马坤 侯团结 李平松

[摘要]目的：探寻一种恢复快、效果稳定自然、操作简便的重睑手术方法。方法：沿设计好的重睑线切开皮肤全层后，保留眼轮匝肌，并通过眼轮匝肌不连续微切口，将眼轮匝肌与上睑提肌腱膜固定，然后间断缝合皮肤，术后观察临床效果。结果：本组共105例就医者，术后效果均较好，术后7～14d基本恢复自然，不良反应轻微，手术操作简单易行，就医者及医生均较满意。结论：保留眼轮匝肌的三点固定切开法重睑术是简单高效的手术方法。

[关键词]重睑术;微创手术;眼轮匝肌;动态重睑

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2020）04-0032-03

Abstract： Objective  To explore a method of blepharoplasty with short recovery time，stable effect，natural appearance and simple operation. Methods  After cutting the whole layer of the skin along the designed double eyelid line， the orbicularis oculi muscle was preserved and the orbicularis oculi muscle and the levator muscle aponeurosis were fixed through the discontinuous microincision of the orbicularis oculi muscle，and then the skin was sutured intermittently. The clinical effect was observed after operation. Results  A total of 105 cases were operated， the postoperative results were good，7 to 14 days after operation basically recovered naturally，the adverse reactions were mild，the operation was simple and easy，and the patients and doctors were satisfied. Conclusion  Three-point fixed incision with orbicularis oculi muscle reserved is a simple and efficient method for blepharoplasty.

Key words： blepharoplasty; minimally invasive surgery; orbicularis oculi muscle; dynamic double eyelid

重睑术是东方人种整形美容外科常见的眼部美容手术[1]，传统的切开法重睑术是切除部分皮肤、眼轮匝肌、脂肪等组织后，将上睑皮肤或眼轮匝肌与睑板或上睑提肌腱膜固定，从而形成牢固的重睑。但是传统的切开法重睑术因术中去除组织多，导致术后恢复时间较长，加大了术后并发症风险以及受术者的生理及心理负担[2]。2016年3月-2019年3月选取上睑皮肤组织较薄、无明显臃肿的单睑就医者，采用保留眼轮匝肌的三点固定切开法重睑術，术后获得满意临床效果及就医者好评。现报道如下。

1  临床资料

本组共105例就医者，其中男性18例，女性87例，年龄18～37岁，平均年龄25.3岁，主诉为单睑或者需要手术改善的不满意重睑，且不伴有严重眉下垂、上睑组织臃肿、眼部炎症或功能性障碍。由经验丰富的整形美容外科医生对105例就医者进行保留眼轮匝肌的三点固定切开法重睑术，其中2例进行单侧重睑术，89例同时行内眦赘皮矫正术。……