【摘要】：目的:既往傳統(tǒng)瞼袋去除眶脂肪術(shù)較為簡單,對下瞼袋臃腫形態(tài)進行簡單處理,而對面中部過渡區(qū)域的淚槽畸形等老化形態(tài)卻沒有改善。本文通過對眶脂肪眶隔弓緣釋放下瞼袋整復(fù)術(shù)和傳統(tǒng)術(shù)式兩種方法進行對比,來研究和探討瞼袋整復(fù)術(shù)中應(yīng)用眶脂肪眶隔弓緣釋放術(shù)修復(fù)下瞼袋方法在臨床應(yīng)用上的優(yōu)勢及其對面中部年輕化的臨床效果。 方法:選用需要進行美容手術(shù)患者36例。將這些患者進行隨機分組,分為兩組,每組18例,一組用傳統(tǒng)瞼袋修復(fù)術(shù)即去除眶脂肪法,一組用眶脂肪眶隔弓緣釋放法瞼袋整復(fù)術(shù),即在瞼袋整形術(shù)基礎(chǔ)上,將眶隔筋膜打開,原有的眶脂肪去除變?yōu)楸Ａ?眶脂釋放并固定于眶下緣的骨膜或軟組織上,以填充眶下緣凹陷區(qū),使下瞼較為豐滿。兩組根據(jù)患者皮膚松弛程度、年齡大小、接受度等情況采用經(jīng)結(jié)膜入路或經(jīng)皮膚入路。在瞼袋下緣凹陷區(qū)任意定點,測量它與鼻尖所在且與面部平行的垂直平面的距離,術(shù)前與術(shù)后分別測量,比較和觀察前后距離變化,并進行統(tǒng)計學分析。術(shù)后一年內(nèi)進行隨訪。 結(jié)果:本組共36例,于2009年6月至2010年6月期間,隨訪三個月至一年,術(shù)后1名患者略有腫脹,腫脹消退較慢。發(fā)現(xiàn)用傳統(tǒng)瞼袋修復(fù)方法的患者對手術(shù)較滿意,下瞼臃腫形態(tài)得到明顯改善,但是淚槽凹陷等狀況改善不明顯;有些患者面中部骷髏狀老化形態(tài)會逐漸顯現(xiàn)。應(yīng)用眶脂肪眶隔弓緣釋放術(shù)的患者均對手術(shù)效果滿意,下眼瞼袋狀外觀均消失或改善,下瞼眶緣溝、鼻頰溝、眶頰溝等凹陷畸形得到緩解和解決,明顯得到矯正,恢復(fù)自然、圓潤、豐滿的下瞼輪廓。外眼角、下眼瞼及內(nèi)眥處無明顯變化,無眼瞼外翻、溢淚、內(nèi)外眥變形、術(shù)后復(fù)發(fā)、下瞼凹陷等并發(fā)癥。術(shù)前與術(shù)后通過測量數(shù)據(jù)發(fā)現(xiàn)應(yīng)用傳統(tǒng)瞼袋方法測量的距離在術(shù)后變化不明顯,說明去除眶脂肪后,只是改變其下瞼松弛和臃腫形態(tài);而應(yīng)用眶脂肪眶隔弓緣釋放法術(shù)后的距離較術(shù)前減小,說明下瞼凹陷區(qū)域被眶隔脂肪下移填平,凹陷區(qū)域得以改善,使面中部過渡區(qū)得以顯現(xiàn)年輕化。 結(jié)論:保留眶脂肪的眶脂肪眶隔弓緣釋放瞼袋整復(fù)術(shù)是應(yīng)用弓緣釋放法和眶區(qū)脂肪轉(zhuǎn)移,這種手術(shù)方法是非常有效的方法,同時能使面部年輕化。結(jié)合被釋放并下移的眶脂肪組織,充填于瞼袋凹陷處,與單純瞼袋修復(fù)術(shù)相比,恢復(fù)自然形態(tài)。對于鼻頰溝、下眶緣溝及眶頰溝等溝槽畸形患者,較為適合這種手術(shù)。從解剖學角度解釋成因,從面部衰老征象產(chǎn)生機制矯正瞼袋畸形,使其更合理、自然,能夠達到眶區(qū)面中部年輕化的效果。
[Abstract]:Objective: the traditional eyelid bag removal of orbital fat was simple, the lower eyelid pouch was simple to deal with, but the deformity of lacrimal groove in the middle transitional area was not improved. In this paper, the orbital fat orbital septal arch margin release lower eyelid bag restoration and traditional operation methods were compared. To study the clinical advantages of orbital fat orbital septal arch release in lower eyelid pouch restoration and the clinical effect of rejuvenation in the middle part of the eyelid. Methods: 36 patients with cosmetic surgery were selected. These patients were randomly divided into two groups, 18 cases in each group. One group was treated with traditional blepharoplasty, that is, orbital fat removal, and the other group was treated with orbital fat release method, which was based on blepharoplasty. According to the degree of skin relaxation, age, acceptance and so on, the two groups adopted transconjunctival approach or transdermal approach. The distance between the nasal tip and the vertical plane parallel to the face was measured at any point in the lower margin of the palpebral pouch. The changes of the distance before and after operation were compared and observed, and the statistical analysis was carried out. All patients were followed up within one year after operation. Results: from June 2009 to June 2010, 36 cases were followed up for 3 months to 1 year. It was found that the patients with traditional blepharoplasty were satisfied with the operation, the lower eyelid bloated shape was obviously improved, but the lacrimal groove depression was not obviously improved, and some patients' middle face skull-shaped aging form would gradually appear. All the patients treated with orbital fat release from orbital septum were satisfied with the results of the operation, the baggy appearance of lower eyelid disappeared or improved, the depression deformity of lower eyelid orbital margin sulcus, nasobuccal sulcus and orbital buccal sulcus were alleviated and resolved, and were obviously corrected and restored to nature. Round, plump lower eyelid outline. There were no obvious changes in the external angle, lower eyelid and inner canthus, no ectropion, tears, medial and medial canthus deformation, postoperative recurrence, lower eyelid depression and other complications. It was found that the distance measured by the traditional eyelid bag method was not obvious after operation, which indicated that the lower eyelid flabby and bloated only changed after the removal of orbital fat. However, the distance after the application of orbital fat orbital septal arcuate spell is smaller than that before operation, which indicates that the lower eyelid depression region is filled down by orbital septum fat, the depression area can be improved, and the transition area in the middle face will appear younger. Conclusion: orbital fat release blepharoplasty is a very effective method for orbital fat transfer and facial rejuvenation. The orbital adipose tissue, which was released and removed, was filled in the pouch of the eyelid and restored to its natural shape compared with the simple blepharoplasty. For patients with naso-buccal sulcus, inferior orbital sulcus and orbitobuccal sulcus, this operation is more suitable. To explain the cause of formation from anatomic point of view, to correct eyelid pouch malformation from the mechanism of facial aging sign, make it more reasonable and natural, can achieve the effect of the middle face of orbital area being younger.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R779.6;R622

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