王慧　葛聪

[摘要]目的：探讨联合筋膜鞘悬吊术（Combined fascial sheath suspension，CFSS）治疗重度上睑下垂的效果及患者满意度。方法：选取笔者医院拟实施手术治疗的100例重度上睑下垂患者作为研究对象，采用随机数字表法分为观察组（采用CFSS手术）和对照组（采用额肌瓣悬吊术治疗），各50例，对比两组患者手术后的上睑上提量、术后上睑缘高度治疗效果、眼睑闭合程度、并发症发生率及患者满意度。结果：术后1个月，观察组患者的上睑上提量高于对照组，差异有统计学意义（P<0.05）;术后3个月，观察组患者的上睑上提量与对照组比较差异无统计学意义（P>0.05）。术后3个月，观察组手术效果、眼睑闭合程度与对照组比较，差异无统计学意义（P>0.05）。观察组患者满意度优于对照组，且观察组并发症发生率为6.00%低于对照组的20.00%，差异有统计学意义（P<0.05）。结论：CFSS治疗重度上睑下垂的效果可靠，术后患者满意度高，手术并发症发生率更低。

[关键词]联合筋膜鞘悬吊术;额肌瓣悬吊术;上睑下垂;重度;满意度

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2020）08-0016-03

Clinical Observation of Combined Fascial Sheath Suspension in the Treatment of Severe Ptosis

WANG Hui，GE Cong

（Department of Plastic Surgery，Sichuan Yuehao Medical Cosmetology Hospital，Chengdu 610036，Sichuan，China）

Abstract： Objective  To investigate the effect of combined fascial sheath suspension （CFSS） in the treatment of severe ptosis and patient satisfaction.  Methods  100 patients with severe ptosis who underwent surgical treatment in our hospital were selected as the study subjects. The randomized digital table method was divided into the observation group （using CFSS surgery） and the control group （using frontalis muscle flap suspension）. The upper sacral volume， postoperative upper iliac crest height treatment， eyelid closure， surgical complications， and postoperative treatment satisfaction were compared between the two groups. Results  One month after operation， the upper eyelid lifting volume of the observation group was higher than that of the control group， the difference was statistically significant （P<0.05）. 3 months after operation， there was no significant difference in the amount of upper eyelid lift between the two groups （P>0.05）. 3 months after operation， there was no significant difference in the operation effect and eyelid closure between the observation group and the control group （P>0.05）. The satisfaction of patients in the observation group was better than that in the control group， and the incidence of complications in the observation group was 6.00%， lower than that in the control group （20.00%， P<0.05）. Conclusion  The effect of CFSS in the treatment of severe ptosis is reliable， postoperative patient satisfaction is high， and the operative complication rate is lower.

Key words： combined fascial sheath suspension; frontalis muscle flap suspension; ptosis; severe; satisfaction

上瞼下垂主要是因先天性发育畸形，多为支配其运动的动眼神经发育不良及提上睑肌发育不全乃至缺失所致，不仅影响了患者容貌，还能对视觉发育产生严重影响，诱发剥脱性弱视，影响患者的身心健康发展。额肌瓣悬吊术是临床上睑下垂的主要治疗方法，但研究[1]发现额肌瓣悬吊术缺点也较多，可导致瘢痕并丧失眼睑皱褶，还可能引起线结周围组织炎症，导致血肿及化脓感染，降低手术效果。国外学者研究[2]提示联合筋膜鞘悬吊术（Combined fascial sheath suspension，CFSS）治疗上睑下垂更加符合抬眼皮生理功能，对额肌先天发育差或额肌外伤、面神经麻痹致额肌功能较差患者，额肌瓣悬吊或超量提上睑肌缩短术后复发患者均具有较满意的疗效。故而……