邓莹莹 丁慰祖

[摘要]目的：探讨运用改良三点式重睑术矫治上睑皮肤松弛的疗效及美学效果。方法：共收集笔者医院整形外科2017年1月-2018年6月接受重睑术矫治的78例上睑皮肤松弛患者，随机数表法分为对照组和研究组，两组各39例。对照组采用切开法及缝线法等传统重睑术治疗，观察组运用改良三点式重睑术矫治，比较兩组手术疼痛、术后恢复时间、一期愈合及并发症发生情况等，结合典型病例分析改良三点式重睑术矫治的美学效果。结果：研究组术后VAS评分明显低于对照组[（2.2±0.8）分 VS（2.7±1.1）分]，术后恢复时间显著短于对照组[（35.4±6.1）d VS（72.6±10.5）d]，差异均有统计学意义（t=2.296、19.131，P<0.05）。研究组均一期愈合，术后重睑弧线流畅自然，双眼对称，面部自然，且未见并发症发生。研究组患者就上睑皮肤松弛矫正美学效果的总满意度为100.00%，明显高于对照组（87.18%），差异有统计学意义（P<0.05）。结论：运用改良三点式重睑术矫治上睑皮肤松弛，不仅手术疼痛感轻、术后恢复时间短和并发症少，而且改善睑部形态效果显著，达到满意的整形美学效果，值得临床推广应用。

[关键词]上睑皮肤松弛;改良三点式重睑术;传统重睑术;切开法;缝线法;美学效果

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2020）08-0004-04

Clinical and Aesthetic Evaluation of Modified Three-point Double Eyelid Surgery for Correction of Upper Eyelid Skin Relaxation

DENG Ying-ying，DING Wei-zu

（Department of Ophthalmology，Shanghai Eighth People's Hospital，Shanghai 200235，China）

Abstract： Objective  To explore the effect and aesthetic effect of modified three-point double eyelid operation for correction of upper eyelid skin relaxation. Methods  A total of 78 patients with upper eyelid skin relaxation who underwent double eyelid surgery from January 2017 to June 2018 in our hospital were randomly divided into the control group and the research group， 39 cases in each group. The control group was treated with traditional double eyelid surgery such as incision and suture. The research group was treated with modified three-point double eyelid surgery. The operation pain， recovery time， primary healing and complications were compared between the two groups. The aesthetic effect of modified three-point double eyelid surgery was analyzed with typical cases. Results  The VAS score of the research group was significantly lower than that of the control group [（2.2±0.8） VS （2.7±1.1）]， the difference was statistically significant（t=2.296，P<0.05）. The recovery time of the research group was significantly shorter than that of the control group [（35.4±6.1）d VS （72.6±10.5）d， P<0.05]. All patients in the research group healed in stage I. The double eyelid arc was smooth and natural after operation. The eyes were symmetrical and the face was natural. No complications occurred. The total satisfaction of the patients in the research group was 100.00%， which was significantly higher than that in the control group （87.18%， P<0.05）. Conclusion  The application of modified three-point double eyelid operation to correct upper eyelid skin relaxation not only has mild pain， short recovery time and fewer complications， but also has remarkable effect on improving eyelid morphology， and achieves satisfactory plastic aesthetic effect， which is worthy of clinical application.

Key words： upper eyelid skin relaxation; improved three-point double eyelid surgery; traditional double eyelid surgery; incision; suture; aesthetic effect

上瞼皮肤松弛作为美容整形外科常见的疾病类型，多由生理退行性衰老所致，年龄增长过程中皮肤质地老化和胶原蛋白流失，引起肌肤弹性下降和上睑皮肤松弛，此外还和酗酒、遗传、用眼习惯、月经周期、睡眠障碍等因素有关[1-2]。上睑皮肤松弛不仅使患者视野变小，而且影响面部整体美观，如“三角眼”、“眯缝眼”、“八字眼”等眼部形态，严重影响患者精神面貌、自我形象认知和心理健康，且随着社会女性对美的需求不断提高，进一步加剧对生活质量的消极影响[3]。重睑术能对上睑下垂进行有效矫治，恢复睑部形态的自然美学效果，比较常用的重睑术有切开法、埋线法及缝线法等，临床运用已较为成熟，但也存在术后恢复较慢、瘢痕明显、重睑线易消失等不足[4-5]。……