摘要
目的:探究改良缝线法与皮肤眼轮匝肌部分切除术对儿童下眼睑内翻倒睫疗效及美观度影响。方法:选取2020年1月-2023年7月收治的下眼睑内翻倒睫患儿82例进行研究,依据治疗方法不同,将采用改良缝线法治疗44例的分为缝线组(73只眼),采用皮肤眼轮匝肌部分切除术治疗的分为切除组38例(64只眼)。比较两组治疗效果,比较术前、术后1周两组眼健康状态[眼表疾病指数(OSDI)问卷、最佳矫正视力(BCVA)]、眼部微环境[泪河高度(TMH)、非侵入性泪膜破裂时间(NIBUT)和干眼症状评估问卷(SPEED)]和美观度[温哥华瘢痕量表美观度问卷(VSS)],随访并发症与复发情况。结果切除组治疗总有效率(90.63%)显著高于缝线组(78.08%)(P<0.05);术后,两组OSDI明显降低(P<0.05),BCVA明显提高(P<0.05),切除组与缝线组间差异有统计学意义(P<0.05);术后,两组NIBUT和TMH均明显提高(P<0.05),SPEED明显降低(P<0.05);且切除组与缝线组间差异有统计学意义(P<0.05);术后6个月,切除组瘢痕色泽、下睑睫毛自然度和双下睑对称度评分显著高于缝线组(P<0.05),瘢痕厚度差异无统计学意义(P>0.05);切除组并发症发生率(4.69%)与缝线组(13.70%)比较差异无统计学意义(P>0.05),复发率(3.13%)显著低于缝线组(12.33%)(P<0.05)。结论:相较于改良缝线法,皮肤眼轮匝肌部分切除术远期疗效更佳,对眼部微环境和眼健康状况改善效果更好,美观度较高,未增加不良并发症,复发率低,临床可根据病情实际选择合适术式。
Objective To explore the influence of modified suture method and partial resection of skin orbicularis oculi muscle on efficacy and aesthetics of lower eyelid entropion and trichiasis in children.Methods 82 children with lower eyelid entropion and trichiasis were selected for study from January 2020 to July 2023 According to different treatment methods,44 cases(73 eyes)treated with modified suture method were included in suture group,and 38 cases(64 eyes)who were treated with partial resection of skin orbicularis oculi muscle were enrolled as resection group.The therapeutic effect,eye health status[ocular surface disease index(OSDI)questionnaire,best corrected visual acuity(BCVA)],eye microenvironment[tear meniscus height(TMH),non-invasive break-up time(NIBUT),standard patient evaluation of eye dryness(SPEED)]and aesthetics[Vancouver scar scale(VSS)]before surgery and at 1 week after surgery,follow-up complications and recurrence were compared between both groups.Results The total effective rate of treatment in resection group(90.63%)was significantly higher than that in suture group(78.08%)(P<0.05).After surgery,the OSDI in the two groups was decreased significantly(P<0.05)while the BCVA was increased significantly(P<0.05),and the differences between resection group and suture group were statistically significant(P<0.05).The NIBUT and TMH in both groups after surgery were significantly risen(P<0.05)while the SPEED was significantly declined(P<0.05),and there were statistical differences between resection group and suture group(P<0.05).At 6 months after surgery,the scores of scar color,lower eyelid eyelash naturalness and lower eyelid symmetry in resection group were significantly higher than those in suture group(P<0.05),and there was no significant difference in scar thickness(P>0.05).There was no significant difference in the incidence of complications between resection group(4.69%)and suture group(13.70%)(P>0.05),and the recurrence rate(3.13%)was significantly lower than that in suture group(12.33%)(P<0.05).Conclusion Compared with modified suture method,partial resection of skin orbicularis oculi muscle has better long-term efficacy,better improvement effect on eye microenvironment and eye health status and higher aesthetics,and it will not increase adverse complications and has low recurrence rate.The appropriate surgical method can be selected according to the actual condition.
作者
乐嘉敏
占梦琪
杨玲
黄琼
LE Jiamin;ZHAN Mengqi;YANG Ling;HUANG Qiong(Department of OphthalmologyⅡ,Wuhan University People's Hospital,Wuhan 430060,Hubei,China;Department of OphthalmologyⅣ,Wuhan University People's Hospital,Wuhan 430060,Hubei,China)
出处
《中国美容医学》
2025年第6期12-16,共5页
Chinese Journal of Aesthetic Medicine
关键词
下睑倒睫
改良缝线法
眼轮匝肌部分切除术
疗效
美观度
lower eyelid trichiasis
modified suture method
partial excision of skin orbicularis oculi muscle
efficacy
aesthetics
作者简介
通信作者:黄琼,副主任护师,研究方向为眼科护理。E-mail:892564013@qq.com;第一作者:乐嘉敏,主管护师,研究方向为眼科护理。E-mail:yjm95828@163.com。
