【摘要】： 目的：隨著年齡的增長(zhǎng),面部衰老最早表現(xiàn)為上瞼老化征象：皮膚松弛,出現(xiàn)皺褶,外眥下垂,嚴(yán)重者影響視野；額肌松弛,眉下垂；部分由于眶隔筋膜松弛,眶脂脫出,上瞼呈現(xiàn)臃腫,部分眶脂萎縮,上瞼凹陷；部分出現(xiàn)不同程度上瞼下垂。通過(guò)對(duì)中老年上瞼老化表現(xiàn)和解剖學(xué)變化的整體研究,探討一種針對(duì)中老年上瞼老化的較簡(jiǎn)單、損傷小且一次性改善上瞼周?chē)匣癄顟B(tài)的手術(shù)方法。 方法：門(mén)診手術(shù)病例84例,均為女性,年齡40-80歲,上瞼均存在不同程度老化外觀。針對(duì)眉形好且原有重瞼線(xiàn)者采用眉緣切口,根據(jù)眉與瞼緣間距采用眉上、下緣不同切口；針對(duì)眉形不佳者采用眉部切口,切除部分眉毛；針對(duì)患者單瞼有重瞼要求者行重瞼切口；針對(duì)上瞼松弛嚴(yán)重者行瞼緣切口；對(duì)眉下垂且有重瞼要求者行提切眉聯(lián)合重瞼切口；術(shù)中針對(duì)不同情況切除多余的皮膚、脂肪和松弛的眼輪匝肌等。針對(duì)老年性上瞼凹陷,采用眉緣切口額肌筋膜瓣折疊轉(zhuǎn)移的方法,填充凹陷。針對(duì)老年性上瞼下垂,采用眉緣切口額肌筋膜-上瞼提肌腱膜復(fù)合瓣折疊懸吊的方法。 結(jié)果：門(mén)診84例病人均實(shí)施了上瞼年輕化手術(shù),從而矯正了眉下垂、上瞼松弛、上瞼凹陷及老年性上瞼下垂等多個(gè)上瞼老化表現(xiàn)。術(shù)后重瞼及眉形自然,瘢痕不明顯,上瞼老化現(xiàn)象得以糾正。 結(jié)論：對(duì)于上瞼老化者,采用多元切口及額肌筋膜瓣、額肌筋膜-上瞼提肌腱膜復(fù)合瓣整復(fù)的手術(shù)方法可最大限度地改善上瞼松弛,糾正老年性上瞼凹陷及老年性上瞼下垂。此方法操作簡(jiǎn)單,對(duì)組織損傷小,使功能得到改善并達(dá)到持久的眼瞼美化、年輕化。患者易于接受,效果好。
[Abstract]:Objective: with the increase of age, the first sign of facial aging is upper eyelid aging: skin flabby, wrinkle, lateral canthus drooping, serious affecting visual field; frontal muscle relaxation, eyebrow prolapse; orbital fat prolapse due partly to orbital septal fascia relaxation. The upper eyelid is bloated, some orbital fat atrophy, upper eyelid depression, and some blepharoptosis. Based on the overall study of the aging appearance and anatomical changes of upper eyelid in middle and old age, this paper discusses a simple method for the aging of upper eyelid in middle and old age, which has less damage and improves the aging state of upper eyelid around the upper eyelid at one time. Methods: 84 cases of outpatient operation were all female, aged 40-80 years. For those with good eyebrow shape and original double eyelid line, eyebrow margin incision was adopted, according to the distance between eyebrow and eyelid margin, different incision was adopted in lower margin, and eyebrow incision was used to remove part of eyebrow for those with poor eyebrow shape. Double eyelid incision for patients with single eyelid with double eyelid requirement; eyelid margin incision for severe upper eyelid relaxation; lifting eyebrow incision combined with double eyelid incision for those with lower eyebrow and double eyelid; excision of redundant skin according to different conditions, Fat and loose orbicularis oculi muscle, etc. For the senile upper eyelid depression, the forehead fascia flap was folded and transferred through the brow margin incision to fill the depression. In view of senile ptosis, the frontalis fascia and upper eyelid levator tendon composite flap was used to fold and suspend the upper eyelid levator tendon flap. Results: 84 cases of outpatients underwent upper eyelid rejuvenation operation, which corrected many signs of upper eyelid aging, such as eyebrow ptosis, upper eyelid relaxation, upper eyelid depression and senile blepharoptosis. After operation double eyelid and eyebrow shape are natural, scar is not obvious, upper eyelid aging phenomenon can be corrected. Conclusion: for the aged upper eyelid, multiple incision and frontalis fascia flap, frontalis fascia and upper eyelid levator tendon composite flap can greatly improve the upper eyelid relaxation and correct the senile upper eyelid depression and senile ptosis. This method is easy to operate, has less tissue damage, improves the function and achieves lasting eyelid beautification and rejuvenation. The patient is easy to accept and the effect is good.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類(lèi)號(hào)】：R779.6

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本文編號(hào)：2178125