保留眼轮匝肌肌皮瓣切开法重睑术的临床疗效分析

Clinical Analysis of Blepharoplasty with Preservation of Orbicularis Oculi Myocutaneous Flap

目的:探讨保留眼轮匝肌肌皮瓣切开法重睑术的临床疗效。方法:选取2019年6月-2020年1月于重庆医科大学附属第一医院整形烧伤外科行双侧切开重睑成形术患者100例,随机分为实验组和对照组,各50例。实验组施行保留眼轮匝肌肌皮瓣重睑术,对照组施行传统重睑术。对比分析两组术后上眼睑肿胀情况、切口瘢痕、重睑形态、并发症及患者满意度。结果:实验组术后1d、2d、3d、4d、1周、2周、3周、4周肿胀评分均低于对照组,实验组术后6个月切口瘢痕评分、重睑形态等级评分均低于对照组,实验组术后1个月、6个月满意度评分均高于对照组,差异均有统计学意义(P<0.05)。实验组重睑变浅发生率高于对照组,实验组台阶感发生率低于对照组,差异有统计学意义(P<0.05)。但两组重睑不流畅发生率比较差异无统计学意义(P>0.05)。结论:保留眼轮匝肌肌皮瓣切开重睑术术后肿胀轻,恢复快,瘢痕不明显,重睑更自然、灵动,操作相对简单,值得推广。

Objective To explore the clinical efficacy of blepharoplasty with preservation of orbicularis oculi myocutaneous flap.Methods A total of 100 patients who underwent bilateral blepharoplasty with the incision method in the department of plastic and burn surgery of the First Affiliated Hospital of Chongqing Medical University from June 2019 to January 2020 were randomly divided into the experimental group(n=50)and the control group(n=50).The experimental group was treated with reserved orbicularis oculi myocutaneous flap in blepharoplasty.The control group was treated with traditional blepharoplasty.The swelling of upper eyelid,the scar of incision,the shape of double eyelid,complications and the postoperative satisfaction of patients were compared and analyzed between the two groups.Results The swelling scores of the experimental group at 1d,2d,3d,4d,1 week,2 weeks,3 weeks and 4 weeks after operation were lower than those in the control group,the differences were statistically significant(P<0.05).The scores of incision scar and double eyelid shape in the experimental group were lower than those in the control group at 6 months postoperatively(P<0.05).The satisfaction scores of the experimental group were higher than those in the control group at 1 month and 6 months after operation(P<0.05).The complications of shallow fold in the experimental group was higher than that in the control group and the“stepped”appearance in the experimental group was lower than that in the control group(P<0.05).There was no significant difference in the complications of unsmooth double eyelid line between two groups(P>0.05).Conclusion The blepharoplasty with orbicularis oculi myocutaneous flap reserved has the advantages of less swelling,quicker recovery,lower scar scores postoperatively,more natural and smart eyelids,simple operation steps,which is worthy of promotion.