刘伟 刘晖

[摘要]目的：比较灰线切开联合睑板前筋膜填充术和Hotz术矫正瘢痕性上睑内翻合并倒睫的临床效果。方法：选取笔者医院72例瘢痕性上睑内翻合并倒睫患者，依照手术方案不同分为研究组（n=36）、常规组（n=36）。常规组采用Hotz术治疗，研究组采用灰线切开联合睑板前筋膜填充术治疗，两组均随访1年。结果：研究组有效率97.22%、复发率2.78%，常规组有效率83.33%、复发率16.67%，组间比较差异均有统计学意义（P<0.05）。研究组眼表疾病指数量表（Ocular surface disease index，OSDI）评分、泪膜破裂时间（Tear break-up time，TBUT）较术前无明显变化（P>0.05），而常规组OSDI评分、TBUT较术前改变明显，差异有统计学意义（P<0.05）。结论：灰线切开联合睑板前筋膜填充术治疗瘢痕性上睑内翻合并倒睫安全有效，复发率低，可以减少干眼症的发生。

[关键词]瘢痕性睑内翻;倒睫;灰线切开联合睑板前筋膜填充术;Hotz术;睑缘灰线;干眼症;疗效

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）01-0004-03

Comparison of Gray Line Incision Combined with Anterior Fascia Filling and Hotz Operation in the Treatment of Cicatricial Entropion with Trichiasis

LIU Wei1，LIU Hui2

（1.Department of Ophthalmology，the Central Hospital of Xiangtan，Xiangtan 411100，Hunan，China;2.Xiangtan Medicine & Health Vocational College，Xiangtan 411100，Hunan，China）

Abstract： Objective  To compare the clinical effect of gray line incision combined with anterior fascia filling and Hotz operation in the correction of cicatricial entropion with trichiasis. Methods  72 cases with cicatricial entropion with trichiasis were divided into the study group （n=36） and the routine group （n=36）. The routine group was treated with Hotz operation and the study group with gray line incision and anterior fascia filling， both groups were followed up for one year. Results  The effective rate of the study group was 97.22%， the recurrence rate was 2.78%， the effective rate of the routine group was 83.33%， the recurrence rate was 16.67%. The differences between the two groups were statistically significant（P<0.05）. The OSDI score and TBUT of the study group had no significant changes compared with those before operation（P>0.05）. The OSDI score and TBUT in the routine group were significantly changed compared with those before operation， and the differences were statistically significant（P<0.05）. Conclusion  It is safe and effective to treat cicatricial entropion of the upper eyelid with gray line incision and anterior fascia filling， which can reduce the incidence of dry eye and reduce the recurrence rate..

Key words： cicatricial entropion; trichiasis; gray line incision combined with anterior fascia filling; Hotz operation; gray line of eyelid margin; dry eye; curative effect

瘢痕性上瞼内翻合并倒睫是眼科常见病、多发病。笔者所在科室2017年10月-2019年12月，对72例瘢痕性上睑内翻合并倒睫患者分别行灰线切开联合睑板前筋膜填充术及Hotz术治疗，比较两组手术效果及术后情况。

1  资料和方法

1.1 一般资料：2017年10月-2019年12月笔者科室诊治了72例瘢痕性上睑内翻合并倒睫患者，依照手术方案不同分为研究组（n=36）、常规组（n=36）。研究组男12例，女24例，年龄46～82岁，平均年龄（63.00±6.11）岁。常规组男19例，女17例，年龄44～83岁，平均年龄（62.00±5.09）岁。两组患者一般资料比较差异无统计学意义（P>0.05）。排除外伤、小睑裂综合征、眼睑痉挛所致的睑内翻。

1.2 方法

1.2.1 研究组：行灰线切开联合睑板前筋膜填充术。患者取仰卧位，距上睑缘约4～5mm按重睑设计方式标记切口线，根据皮肤松弛程度确定去皮量。常规消毒铺巾，2%利多卡因+0.75%布比卡因+1/20万肾上腺素混合液1.5ml行上睑皮下局部浸润麻醉。尖……