周长磊 冷向锋

[摘要]目的：探讨眶周穿支皮瓣与耳软骨及口腔黏膜共同修复全层眼睑缺损的效果及对美观功能评分的影响。方法：选取2018年1月-2018年12月笔者医院收治的全层眼睑缺损患者92例，所有患者均进行眶周穿支皮瓣与耳软骨及口腔黏膜共同修复。分析患者修复效果、比较修复前后睑裂高度差值、睑裂长度差值、美观功能评分、抑郁、焦虑及并发症情况。结果：92例患者中，有效率为84.8%（78/92）;并发症发生率为30.4%（28/92）。修复后睑裂高度差值、睑裂长度差值、抑郁、焦虑评分小于修复前，修复后美观功能评分高于修复前，差异有统计学意义（P<0.05）。结论：全层眼睑缺损修复中，眶周穿支皮瓣与耳软骨及口腔黏膜共同修复效果显著，值得临床应用。

[关键词]眶周穿支皮瓣;耳软骨;口腔黏膜;联合修复;全层眼睑缺损;美观功能评分

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2021）11-0045-03

Repair of Full-thickness Eyelid Defect with Periorbital Perforator Flap Combined with Ear Cartilage and Oral Mucosa

ZHOU Chang-lei，LENG Xiang-feng

（Department of Plastic Surgery，the Affiliated Hospital of Qingdao University，Qingdao 266000，Shandong，China）

Abstract： Objective  To investigate the effect of periorbital perforator flap combined with ear cartilage and oral mucosa in the repair of full-thickness eyelid defect and its influence on aesthetic function score. Methods  92 patients with full-thickness eyelid defect in our hospital from January 2018 to December 2018 were selected. All patients were repaired with periorbital perforator flap， ear cartilage and oral mucosa. The repair effect was analyzed， and the height difference， length difference， aesthetic function score， depression， anxiety and complications were compared before and after repair. Results  In 92 patients，  the effective rate was 84.8% （78/92）. The incidence of complications was 30.4% （28/92）. The difference of eyelid fissure height， eyelid fissure length， depression and anxiety scores after repair were lower than those before repair， and the aesthetic function score after repair was higher than that before repair， the differences were statistically significant （P<0.05）. Conclusion  In the repair of full-thickness eyelid defect， the periorbital perforator flap combined with ear cartilage and oral mucosa have a significant effect， which is worthy of clinical application.

Key words： periorbital perforator flap; ear cartilage; oral mucosa; joint repair; full thickness eyelid defect; aesthetic function score

眼睑是眼球的重要附属物，作用是防止强光损伤眼球、异物损伤眼球，同时可以维持面部面容[1]。一旦发生全层眼睑缺損需要及时进行修复治疗。眼睑结构较为复杂，由皮肤、结缔组织、肌肉、腺和结膜组成，修复缺损目的为恢复眼睑解剖结构，维持眼睑的正常功能与形态。眼睑肿瘤是临床常见的眼部疾病，手术切除是主要的治疗方法，但是，由于切除的范围较大，术后会出现较大的全层眼睑缺损，对患者的眼部功能、美观程度造成影响，因此，寻找有效的修复方法及时进行修复非常重要[2]。笔者医院在眼睑修复中，使用眶周穿支皮瓣与耳软骨及口腔黏膜共同修复，效果显著，报道如下。

1  资料和方法

1.1 一般资料：选取2018年1月-2018年12月笔者医院收治的全层眼睑缺损患者92例，所有患者均由眶周穿支皮瓣与耳软骨及口腔黏膜共同修复。……