眉下切口提眉术联合重睑成形术治疗中重度上睑松弛疗效分析

Therapeutic Effect of Eyebrow Lifting through an Incision under Eyebrow Combined with Double Eyelid Surgery in the Treatment of Moderate⁃severe Ptosis

目的探讨眉下切口提眉术联合重睑成形术治疗中重度上睑松弛的临床效果。方法选取2019年3月至2020年12月河南科技大学第一附属医院收治的112例中重度上睑松弛患者作为研究对象,按照不同治疗方法将其分为联合组(60例)与重睑成形术组(52例),联合组患者采用眉下切口提眉术联合重睑成形术治疗,重睑成形术组患者单纯采用重睑成形术治疗,对比观察两组患者上睑松弛矫正效果、上睑皱纹改善程度以及术后不良事件发生情况。结果术后6个月,联合组患者矫正效果优良率为96.67%,明显高于重睑成形术组患者的矫正效果优良率86.54%(χ^(2)=3.867,P=0.049);术后1、3、6个月,联合组患者上睑Lemperle评分均明显低于重睑成形术组(t=2.286、2.063、2.082,P=0.024、0.042、0.040);术后6个月内,联合组患者不良事件发生率为5.00%,重睑成形术组患者不良事件发生率为3.85%,两组间无明显差异(χ^(2)=0.087,P=0.768)。结论眉下切口提眉术联合重睑成形术治疗中重度上睑松弛,可充分切除上睑松弛皮肤组织,减轻上睑皱纹,恢复良好的眉眼部美学关系,疗效显著,安全性较高。

Objective To investigate the therapeutic effect of eyebrow lifting through an incision under eyebrow combined with double eyelid surgery in the treatment of moderate⁃severe ptosis.Methods 112 patients with moderate⁃severe ptosis,admitted into The First Affiliated Hospital of Henan University of Science and Technology between March 2019 and December 2020,were enrolled into research subjects,and divided into combination group(n=60),receiving the eyebrow lifting through an incision under eyebrow combined with double eyelid surgery,and double eyelid surgery group(n=52),receiving double eyelid surgery only.The correction effect of ptosis,improvement of upper eyelid wrinkles and occurrence of adverse reactions after surgery were compared between the two groups.Results At month 6 after surgery,the rate of excellent and good correction effect was 96.67%in combination group,being obviously higher than the corresponding 86.54%in double eyelid surgery group(χ^(2)=3.867,P=0.049).Respectively at month 1,month 3 and month 6 after sur⁃gery,the Lemperle scores of upper eyelids in combination group were markedly lower than control group(t=2.286,2.063 and 2.082,P=0.024,0.042 and 0.040).During the six months after surgery,the incidence of adverse reactions was 5.00%in combination group,and 3.85%in double eyelid surgery group,between which no significant difference was observed(χ^(2)=0.087,P=0.768).Conclusion The combined application of eyebrow lifting through an incision under eyebrow and double eyelid surgery in the treatment of ptosis can remove the droopy tissues of upper eyelids completely,reduce the wrinkles of upper eyelids,restore good eyebrow aesthetics with definite therapeutic effect and safety.