高频电刀在重睑成形术中的应用效果

Effect of high-frequency electric surgical knife in blepharoplasty

目的比较高频电刀和手术刀在重睑成形术中的应用效果。方法回顾性分析上海交通大学医学院附属第九人民医院2021年1月至7月收治的眼部整形者35例(70眼),随机选取一侧眼为高频电刀组(采用高频电刀行手术),另一侧眼为手术刀组(采用手术刀行手术),每组35眼。评估术后双眼重睑成形效果。术后1 d、1周、1个月及3个月观察患者肿胀情况及瘀斑形成情况。术后1周、1个月、3个月采用曼彻斯特瘢痕量表(MSS)评估患者瘢痕情况。将切除的组织行HE染色和TUNEL染色,评估皮肤和肌肉的坏死程度和热损伤范围。结果术后患者双眼在肿胀、瘀斑、疼痛及瘢痕形成方面差异均无统计学意义(P>0.05)。高频电刀组眼睑出现肌肉组织凝固性坏死,手术刀组几乎无凝固性坏死;患者双眼术后凝固性坏死肌肉占比比较差异有统计学意义(P<0.05),高频电刀组热损伤深度大于手术刀组(P<0.05)。结论高频电刀在重睑成形术中操作简单,使用安全,术中切凝及时,可获得良好的手术术野及效果。

Objective To compare the application effects of high-frequency electric surgical knife and scalpel in blepharoplasty.Methods A retrospective analysis was performed for 35 patients(70 eyes)who were admitted to the Shanghai Ninth People´s Hospital,Shanghai JiaoTong University School of Medicine from January to July 2021,and one side eye was randomly selected as the high-frequency electric surgical knife group(operated by high-frequency electric surgical knife)and the other side eye as the scalpel group(operated by scalpel),with 35 eyes in each group.The effect of blepharoplasty in both eyes after surgery was evaluated.The swelling and ecchymosis of the patients were observed 1 day,1 week,1 month and 3 months after surgery.The Manchester scar scale(MSS)was used to evaluate the scarring of the patients 1 week,1 month and 3 months after surgery.The excised tissues were stained with HE staining and TUNEL staining to assess the degree of necrosis and the extent of thermal damage to the skin and muscle.Results There was no statistically significant difference in swelling,ecchymosis,pain or scarring after surgery between the two groups(P>0.05).The eyelids of the high-frequency electrosurgical group showed coagulative necrosis of muscle tissue,and the scalpel group had almost no coagulative necrosis.There was statistically significant difference in the proportion of coagulable necrotic muscle after surgery between the two groups(P<0.05),and the depth of thermal damage in the high-frequency electric surgical knife group was greater than that in the scalpel group(P<0.05).Conclusion The high-frequency electric surgical knife in blepharoplasty is simple to operate,and safe to use,with timely intraoperative incision and coagulation,which can obtain good surgical field and effect.