本文選題：眼袋分型 + 手術(shù)方式選擇��； 參考：《浙江大學(xué)》2010年碩士論文

【摘要】： 背景與目的 眼袋是為眶脂肪與下瞼支持結(jié)構(gòu)之間失衡,具體說(shuō)就是下瞼皮膚,皮下組織,肌肉及眶膈松弛,眶后脂肪肥大,向前突出而呈囊袋狀。手術(shù)行眼袋整復(fù)術(shù)是臨床上去除眼袋、恢復(fù)外形美觀的較好且徹底的手段。隨著人們對(duì)自己外在的要求的提高,越來(lái)越多的患者希望通過(guò)整形手術(shù)來(lái)達(dá)到去除眼袋的目的。 不同的患者形成的眼袋表現(xiàn)各有不同,有其不同的局部病理解剖類型特點(diǎn),需進(jìn)行不同類型的手術(shù)。本文把眼袋為5種不同的類型：?jiǎn)渭冄圯喸鸭》蚀笮�、單純皮膚松馳型、單純眶脂肪疝出不伴皮膚松弛型、下瞼膨隆伴皮膚松弛型和皮膚松弛伴眶下緣凹陷型。而同時(shí)又有三種手術(shù)方式：經(jīng)結(jié)膜入路眼袋整復(fù)術(shù)、傳統(tǒng)的皮膚入路眼袋整復(fù)術(shù)以及Hamra術(shù)式,其中傳統(tǒng)的皮膚入路又分為皮瓣法與肌皮瓣法。 我科留有多數(shù)來(lái)科診治的患者的資料,通過(guò)收集并統(tǒng)計(jì)我科2005年2月至2010年2月共5年內(nèi)進(jìn)行眼袋整復(fù)的患者的病例,對(duì)其查體、手術(shù)方式進(jìn)行收集分析,并回訪其是否出現(xiàn)并發(fā)癥,目前手術(shù)效果如何等。主要對(duì)單純脂肪膨出、脂肪膨出伴皮膚松弛及皮膚松弛伴下眶緣凹陷三類患者進(jìn)行分析,以求找到針對(duì)各種不同類型的眼袋,其最有效且合適的外科治療方法。 研究方法 收集并統(tǒng)計(jì)我科2005年2月至2010年2月共5年內(nèi)進(jìn)行眼袋整復(fù)的患者的病例。在此期間,一共有84位計(jì)168側(cè)眼袋患者在我科接受過(guò)治療,年齡范圍為20—60歲,平均年齡49.8歲。其中29人共58側(cè)單純眶脂肪疝出眼袋患者,有39人共78側(cè)下瞼膨隆伴皮膚松弛型眼袋患者,有26人共52側(cè)皮膚松弛伴眶下緣凹陷型眼袋患者。平均隨訪時(shí)間24.5個(gè)月。獲得查體、手術(shù)方式、術(shù)后效果、并發(fā)癥等多方面資料,研究分析各種不同類型眼袋整復(fù)術(shù)的特點(diǎn)。 結(jié)果 1結(jié)膜入路眶隔后及眶隔前入路手術(shù)效果未見顯著性差異。 2行結(jié)膜入路切口≥1 cm時(shí),應(yīng)于內(nèi)、中、外三點(diǎn)定位縫合結(jié)膜下組織,以利于創(chuàng)口對(duì)合生長(zhǎng)。 3中重度下瞼松弛的患者,行眼袋整復(fù)術(shù)時(shí)皮瓣法術(shù)后效果優(yōu)于肌皮瓣法。 4對(duì)于重度下瞼松弛患者,處理外眥是非常必要的,可以減少術(shù)后下瞼外翻、下瞼退縮的發(fā)生率。 5對(duì)于有眶下緣凹陷的患者,行Hamra術(shù)對(duì)于預(yù)防術(shù)后眶下緣凹陷有意義。 結(jié)論 對(duì)不同的眼袋類型,必須仔細(xì)進(jìn)行術(shù)前評(píng)估,選擇其最適合的手術(shù)方式,才能達(dá)到最佳手術(shù)效果,最大程度地減少手術(shù)并發(fā)癥。
[Abstract]:Background and purposeThe pouch is an imbalance between the orbital fat and the lower eyelid supporting structure, specifically, the lower eyelid skin, subcutaneous tissue, muscle and orbital diaphragm are relaxed, and the postorbital fat is hypertrophic, protruding forward and presenting as a sachelike.The operation of pouch reduction is a good and thorough method to remove the pouch and restore the appearance.With the improvement of external requirements, more and more patients hope to remove pouch through plastic surgery.Different patients have different manifestations of pouch, have different characteristics of local pathological anatomy, and need different types of surgery.In this paper, there are five different types of pouch: simple orbicularis oculi muscle fat, simple skin relaxation, simple orbital fat hernia without skin relaxation, lower eyelid swelling with skin relaxation and skin relaxation with lower orbital depression.At the same time, there are three types of operation: transconjunctival pouch reduction, traditional skin pouch reduction and Hamra operation, among which the traditional skin approach is divided into flaps and musculocutaneous flaps.The data of the majority of patients treated in our department were collected and analyzed by collecting and counting the cases of the patients who underwent pouch reduction in 5 years from February 2005 to February 2010, and collecting and analyzing their physical examination and operation methods.And visit back to see if there are complications, the current results of surgery and so on.In order to find out the most effective and suitable surgical treatment for different types of pouch, three kinds of patients were analyzed, which were simple fat exophthalmos, fat exudation with skin relaxation and skin relaxation with lower orbital margin depression.Research methodTo collect and count the cases of pouch reduction in our department from Feb 2005 to Feb 2010.During this period, a total of 84 patients with 168 pairs of pouch were treated in our department, ranging in age from 20 to 60 years, with an average age of 49.8 years.There were 58 cases of simple orbital fat herniation in 29 cases, 78 cases of lower eyelid distention with skin relaxation pouch in 39 cases, and 52 cases of skin flabby with depressed orbital lower margin pouch in 26 cases.The mean follow-up time was 24.5 months.The characteristics of different types of pouch prosthesis were studied and analyzed, including physical examination, surgical methods, postoperative results and complications.Result1 there was no significant difference in the results of operation between the orbital septum and the anterior orbital septum via conjunctival approach.(2) when the incision of conjunctival approach 鈮，

本文編號(hào)：1732176