下睑缩肌移位术联合眼睑轮匝肌折叠缩短术治疗睑内翻的疗效探讨

Effect of lower eyelid retractor muscle transposition combined with fold eyelid orbicularis oculi muscle shortening in the treatment of entropion

目的探讨下睑缩肌移位术联合眼睑轮匝肌折叠缩短术治疗睑内翻的疗效。方法将眼科100例老年单眼睑内翻患者作为研究对象,以随机抽签方式分为对照组(50例)、试验组(50例)。对照组给予下睑缩肌移位术治疗,试验组给予下睑缩肌移位术联合眼睑轮匝肌折叠缩短术治疗。对比两组围术期手术指标(切除皮肤宽度、手术出血量、手术时间),症状和体征(流泪、异物感、畏光)评分,眼部指标(睑裂宽度、泪阜显露率、睫毛朝向)恢复情况,并发症发生率。结果试验组切除皮肤宽度(1.51±0.23)cm小于对照组的(1.65±0.29)cm、手术出血量(38.76±6.76)ml多于对照组的(28.34±5.43)ml、手术时间(31.34±6.34)min长于对照组的(24.65±5.33)min(P<0.05)。治疗后,试验组流泪、异物感、畏光评分分别为(1.12±0.34)、(1.06±0.35)、(1.06±0.44)分,均低于对照组的(1.42±0.76)、(1.72±0.73)、(1.77±0.29)分(P<0.05)。治疗后,试验组睑裂宽度(28.21±3.77)mm、泪阜显露率(0.86±0.17)%、睫毛朝向(96.12±10.14)°均大于对照组的(25.23±2.89)mm、(0.63±0.14)%、(82.67±8.65)°(P<0.05)。试验组并发症发生率为4.00%,较对照组的16.00%更低(P<0.05)。结论睑内翻使用下睑缩肌移位术联合眼睑轮匝肌折叠缩短术进行治疗可将手术质量进行提升,有效改善流泪、异物感等临床症状,并调整睑裂宽度、泪阜显露等指标,控制术后并发症发生率,值得推广普及。

Objective To explore the efficacy of lower eyelid retractor muscle transposition combined with fold eyelid orbicularis oculi muscle shortening in the treatment of entropion.Methods 100 elderly patients with single eyelid entropion in the Department of Ophthalmology were taken as the study subjects and were divided into the control group(50 cases)and the experimental group(50 cases)by random lotterly method.The control group was treated with lower eyelid retractor muscle transposition,and the experimental group was treated with lower eyelid retractor muscle transposition combined with fold eyelid orbicularis oculi muscle shortening.Comparison was made on perioperative indicators(width of excised skin,amount of blood loss,operation time),scores of symptoms and signs(tearing,foreign body sensation,photophobia),recovery of ocular indicators(width of eyelid,exposure rate of the lacrimal caruncle,eyelashes orientation),and incidence of complications between the two groups.Results The experimental group had smaller width of excised skin of(1.51±0.23)cm than(1.65±0.29)cm in the control group,larger amount of blood loss of(38.76±6.76)ml than(28.34±5.43)ml in the control group,and longer operation time of(31.34±6.34)min than(24.65±5.33)min in the control group(P<0.05).After treatment,the scores of tearing,foreign body sensation,photophobia in the experimental group were(1.12±0.34),(1.06±0.35)and(1.06±0.44)points,which were lower than(1.42±0.76),(1.72±0.73)and(1.77±0.29)points in the control group(P<0.05).After treatment,the width of eyelid of the experimental group was(28.21±3.77)mm,the exposure rate of the lacrimal caruncle was(0.86±0.17)%,and the eyelashes orientation was(96.12±10.14)°,which were greater than(25.23±2.89)mm,(0.63±0.14)%,and(82.67±8.65)°in the control group(P<0.05).The incidence of complications of the experimental group was 4.00%,which was lower than 16.00%of the control group(P<0.05).Conclusion For the treatment of entropion,using lower eyelid retractor muscle transposition combined with fold eyelid orbicularis oculi muscle shortening can improve the quality of surgery,effectively improve the clinical symptoms such as tearing and foreign body sensation,and adjust the indexes of width of eyelid and exposure of lacrimal caruncle to control the incidence of postoperative complications,which is worthy of popularization.