双层瓦合眼轮匝肌肌瓣眼袋切除术与四步法整形术对眼袋祛除效果及安全性比较

Comparison of the effect and safety of double over and out orbicularis oculi muscle flap eye bag excision and four-step plastic surgery on the removal of eye bags

目的 比较双层瓦合眼轮匝肌肌瓣眼袋切除术与四步法整形术对眼袋祛除的效果及安全性。方法 选取2019年9月至2021年8月上海交通大学医学院苏州九龙医院收治的89例准备接受眼袋美容整形术治疗的患者,依据摸球法将其分为眼轮匝肌肌瓣组(采用双层瓦合眼轮匝肌肌瓣眼袋切除术治疗,48例)和四步法整形术组(采用四步法整形术治疗,41例)。比较两组术后眼部外观恢复正常时间、眼袋祛除效果、泪沟改善情况,术后随访1年,记录并发症发生情况。结果 两组眼部外观恢复正常时间比较,差异无统计学意义(P>0.05)。眼轮匝肌肌瓣组眼袋祛除效果优于四步法整形术组,差异有统计学意义(P<0.05)。术后,两组Barton分级均优于术前,眼轮匝肌肌瓣组优于四步法整形术组,差异有统计学意义(P<0.05)。眼轮匝肌肌瓣组并发症总发生率低于四步法整形术组,差异有统计学意义(P<0.05)。结论 与四步法整形术比较,采用双层瓦合眼轮匝肌肌瓣眼袋切除术可提高患者的眼袋祛除效果,改善泪沟,降低术后并发症的发生率。

Objective To compare the effect and safety of double over and out orbicularis oculi muscle flap eye bag excision and four-step plastic surgery on the removal of eye bags.Methods A total of 89 patients admitted to Suzhou Jiulong Hospital,School of Medicine,Shanghai Jiao Tong University from September 2019 to August 2021 were going to receive cosmetic plastic surgery for eye bags,and they were selected and divided into the orbicularis oculi muscle flap group(48 cases with double over and out orbicularis oculi muscle flap eye bag excision)and the four-step plastic surgery group(41 cases with four-step plastic surgery)according to the ball-touching method.The time of ocular appearance return to normal,the effect of eye bag removal and the improvement of lacrimal furrow were compared between the two groups.The complications were recorded after one year of postoperative follow-up.Results There was no significant difference in the recovery time of ocular appearance between the two groups(P>0.05).The removal of bags in orbicularis oculi muscle flap group was better than that in four-step plastic surgery group,and the difference was statistically significant(P<0.05).After surgery,Barton grading in both groups was better than that before surgery,and that of orbicularis oculi muscle flap group was better than that of four-step plastic surgery group,the differences were statistically significant(P<0.05).The incidence of complications orbicularis oculi muscle flap group was lower than that in four-step plastic surgery group,and the difference was statistically significant(P<0.05).Conclusion Compared with the four-step plastic surgery,the double over and out orbicularis oculi muscle flap eye bag excision can improve the effect of removing bags,improve lacrimal furrow,and reduce the incidence of postoperative complications.