结膜内切口上颌前间隙眶隔释放矫正年轻患者下睑袋伴泪沟畸形

Intraconjunctival incision anterior maxillary space orbital septal release correction of lower eyelid pouch with tear trough deformity in young patients

目的 探讨结膜内切口上颌前间隙眶隔释放矫正年轻患者下睑袋伴泪沟畸形的临床效果,并对并发症进行分析。方法 自2019年5月至2021年5月,滨州医学院附属医院美容医学部共收治65例下睑袋伴有泪沟畸形的年轻患者,年龄22~35岁。经结膜内切口,离断泪槽韧带、分离上颌前间隙,将带蒂眶隔脂肪瓣填充到泪沟凹陷处并给予牢靠固定,适当去除多余眶隔脂肪。术后随访6个月,对术后效果进行满意度评价,并记录发生的并发症。结果 采取三方满意度调查的方法,针对65例患者130侧眼睛的手术进行效果评价,医生、护士、患者三方评价满意率分别是118侧(90.76%)、120侧(92.30%)、116侧(89.23%)。并发症统计:1侧发生术后24小时内血肿,1例2侧术后三个月时发生血肿,1侧反映长时间的上唇处麻木不适,6侧反映长时间的泪沟处硬结感,以上情况在6个月随访时均消失;4侧反映眼袋、泪沟改善不明显,手术效果欠佳。并发症发生率10.76%,无皮肤坏死、睑外翻、失明、面神经不可逆损伤等严重并发症。结论 结膜内切口上颌前间隙眶隔释放针对下睑袋伴有泪沟畸形的年轻患者,治疗效果好,手术损伤小,满意度高,严重或不可逆的并发症发生几率小。

Objective To investigate the clinical effect of intraconjunctival incision of the anterior maxillary space orbital septum release in correction of lower eyelid pouch with tear trough deformity in young patients,and to analyze the complications.Methods From May 2019 to May 2021,a total of 65 young patients with lower eyelid bag with tear trough deformity were treated by the Department of Aesthetic Medicine of binzhou Medical College,aged 22-35 years old.Through the incision of the conjunctiva,the tear trough ligament is broken,the anterior space of the upper jaw is separated,and the stiled orbital septum fat flap is filled into the tear trough depression and firmly fixed,and the excess orbital septal fat is appropriately removed.Postoperative follow-up was conducted for 6 months,and the satisfaction rate of postoperative effects was evaluated,and complications were recorded.Results The effect evaluation of 130-sided eye surgery in 65 patients was evaluated by means of tripartite satisfaction survey,and the satisfaction rates of doctors,nurses and patients were 118 sides (90.76%),120 sides (92.30%) and 116 sides (89.23%),respectively.Complication statistics:hematoma occurred within 24 hours after surgery on the 1 side,hematoma occurred in 1 case and 2 side three months after surgery,1 side reflected the numbness and discomfort of the upper lip for a long time,and the 6 side reflected the long-term induration of the tear trough,and the above conditions disappeared at 6 months of follow-up;4 sides reflected that the eye bags and tear troughs did not improve significantly,and the surgical effect was not good.The complication rate is 10.76%,and there are no serious complications such as skin necrosis,eyelid valgus,blindness,and irreversible damage to the facial nerve.Conclusions The release of the orbital septum of the anterior maxillary space of the incision in the conjunctiva is aimed at young patients with tear trough deformity in the lower eyelid pouch,and the treatment effect is good,the surgical injury is small,the satisfaction is high,and the probability of serious or irreversible complications is small.