本文選題：眶隔 + 眼輪匝肌��； 參考：《青島大學(xué)》2017年博士論文

【摘要】：目的:探討切緣上方的眼輪匝肌、眶隔固定于瞼板前筋膜在上瞼成形術(shù)中的臨床應(yīng)用及效果。方法:選取要求行重瞼成形術(shù)的美容就醫(yī)者150名,根據(jù)手術(shù)方式的不同分為A、B、C組,每組有50例。分別為改良重瞼成形術(shù)術(shù)式組,傳統(tǒng)重瞼成形術(shù)術(shù)式組,和Park法重瞼成形術(shù)術(shù)式組。其中A組美容就醫(yī)者采用改良重瞼成形術(shù)術(shù)式,將切緣上方的眼輪匝肌近瞼板部分及眶隔膜底部下拉與瞼板前筋膜固定。伴有上瞼中度及重度肥厚者,直接將切口上方的眼輪匝肌與瞼板前筋膜固定,不與眶隔底部縫合。B組美容就醫(yī)者采用傳統(tǒng)重瞼成形術(shù)術(shù)式,單純穿掛瞼板固定縫合皮膚。C組美容就醫(yī)者采用Park法重瞼成形術(shù)術(shù)式將切緣下方的眼輪匝肌與上瞼提肌腱膜內(nèi)固定的雙層縫合方式。術(shù)后6個月,每位患者完成一份問卷,主要從對手術(shù)效果的評價。手術(shù)效果包括雙側(cè)重瞼線對稱性、重瞼線自然流暢性、重瞼寬度、重瞼溝深淺、皮膚肥厚程度。美容就醫(yī)者在優(yōu)、良、可、差4個級別中選擇一項作為評價。通過Likert5點量表,美容就醫(yī)者對每個方面的滿意度進行評分,5=非常滿意,4=滿意,3=一般,2=不滿意,1=非常不滿意。美容就醫(yī)者把自己的具體意見直接寫在調(diào)查問卷上。比較各組患者滿意度得分差異。應(yīng)用SPSS 17.0統(tǒng)計軟件,t檢驗分析各組之間患者年齡的差異;Mann-Whitney U檢驗分析各組間各項滿意度差異,以P0.05為差異有統(tǒng)計學(xué)意義。結(jié)果:150名美容就醫(yī)者均手術(shù)順利。問卷調(diào)查顯示:A組美容就醫(yī)者對所有調(diào)查項目評價均較高,B組有3例美容就醫(yī)者反映重瞼線變淺。C組4例美容就醫(yī)者認為術(shù)后切緣下方肥厚比較明顯;1例美容就醫(yī)者在拆線后出現(xiàn)雙側(cè)重瞼的寬度輕度不對稱,3個月后較前改善,6個月后基本滿意。滿意度統(tǒng)計顯示:A組與B組之間對重瞼溝深淺方面的差異有統(tǒng)計學(xué)意義(P0.05),A組與C組之間對重瞼厚度方面的差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:通過將切緣上方的眼輪匝肌近瞼板部分及眶隔膜底部與瞼板前筋膜固定的改良上瞼成形術(shù)較傳統(tǒng)重瞼成形術(shù)及Park法臨床效果良好,且持久保持。
[Abstract]:Objective: to investigate the clinical application and effect of orbicularis oculi muscle with orbital septum fixed on the prepalpebral fascia in upper eyelid plasty. Methods: 150 patients with double blepharoplasty were divided into two groups: group A (n = 50) and group C (n = 50). They were modified double blepharoplasty group, traditional double blepharoplasty group and Park double blepharoplasty group. Group A was treated with modified double blepharoplasty. The proximal tarsal plate of orbicularis oculi muscle and the orbital septum were pulled down and fixed with the anterior fascia of tarsal plate. In the patients with moderate or severe hypertrophy of upper eyelid, the orbicularis oculi muscle and the anterior fascia of the tarsal plate were fixed directly, without suture to the bottom of the orbital septum. Group B was treated with traditional double blepharoplasty. The double layer suture of orbicularis oculi muscle and upper eyelid levator tendon was performed by Park double eyelid plasty. 6 months after operation, each patient completed a questionnaire, mainly from the evaluation of the results of surgery. The results of operation include symmetry of double eyelid line, natural fluency of double eyelid line, width of double eyelid, depth of double eyelid sulcus and degree of skin hypertrophy. Beauty on the doctor in the excellent, good, fair, poor four levels of choice as an evaluation. According to the Likert5 scale, the cosmetic patients' satisfaction with each aspect was evaluated by 5 = very satisfactory 4 = satisfactory 3 = general 2 = unsatisfactory 1 = very unsatisfactory. Beauty on the doctor to write their own specific opinions directly on the questionnaire. The scores of patients' satisfaction were compared. Mann-Whitney U test was used to analyze the difference of patients' age in each group with SPSS 17.0 statistical software (t test). Results all the 150 cosmetologists were successfully operated on. The questionnaire survey showed that the evaluation of all the survey items in group A was higher than that in group B. There were 3 cases of cosmetic therapy in group B and 4 cases in group C reflecting shallowness of double eyelid line. 4 cases in group C thought that the hypertrophy below the incision margin was obvious in 1 case. The width of double eyelids was slightly asymmetrical, improved after 3 months, and satisfied after 6 months. The statistical results of satisfaction showed that there were significant differences in the depth and depth of double eyelid sulcus between group A and group B. There was significant difference in the thickness of double eyelid between group A and group C (P 0.05). Conclusion: the modified upper eyelid blepharoplasty with the proximal tarsal plate of orbicularis oculi muscle and the base of orbital septum and prepiric fascia is better than that of traditional double eyelid plasty and Park method.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2017
【分類號】：R779.6;R62

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