外眦部梭形皮肤切除与眼轮匝肌缩短术矫治下睑内翻临床效果比较

摘要

目的:探究外眦部梭形皮肤切除与眼轮匝肌缩短术矫正下睑内翻的临床效果.方法:将103例在本院眼科行手术治疗的下睑内翻患者(128眼)作为研究对象,按照入院时间排序,随机分为观察组54例(67眼)和对照组49例(61眼).对照组采用眼轮匝肌缩短术(Wheeler术)进行治疗,观察组采用外眦部梭形皮肤切除术进行治疗.结果:观察组患者的总有效率为92.54%,与对照组(93.44%)相比,差异无统计学意义(P>0.05);观察组和对照组术后并发症发生率分别为8.96%,6.56%,差异无统计学意义(P>0.05);术后6个月、12个月,观察组和对照组患者的复发率比较,差异无统计学意义(P>0.05);术后18个月、24个月,观察组患者的复发率分别为8.96%、11.94%,明显低于对照组(22.95%、31.15%),差异有统计学意义(P<0.05);术后24个月,观察组患者眼部美观总满意度为91.04%,明显高于对照组的75.41%,差异有统计学意义(P<0.05).结论:采用外眦部梭形皮肤切除术矫正下睑内翻的近期疗效与Wheeler术相同,但其术后效果能够长时间保持,术后复发率更低,远期疗效更佳,患者术后美观满意度更高,值得在临床上积极推广.%ObjectiveTo research the clinical effect of lateral canthus fusiform skin excision and orbicularis muscle shortening in patients of lower eyelid entropion.Methods103 cases of lower eyelid entropion (128 eyes) who treated by surgery in our hospital were selected as the subjects. According to admission, the patients were divided into the observation group (54 cases, 67 eyes) and the control group (49 cases, 61 eyes). The control group was treated with orbicularis oculi muscle shortening (Wheeler), and the observation group was treated with lateral canthus fusiform skin excision treatment. Analyzed and compared the clinical efifcacy of the two groups of patients.ResultsThe total effective rate of the observation group was 92.54%, compared with the control group (93.44%), the difference was not statistically signiifcant (P>0.05). The incidences of postoperative complications were 8.96% and 6.56% in the observation group and the control group, respectively. There was no signiifcant difference between the two groups (P>0.05). 6 and 12 months after surgery, the recurrence rate in the observation group and the control group were 4.48%, 7.46% and 6.56%, 4.92%, there was no signiifcant difference between the two groups (P>0.05). 18 and 24 months after operation, the recurrence rate of the observation group were 8.96%, 11.94%, and the control group (22.95%, 31.15%) the difference was statistically signiifcant (P<0.05). After 24 months, the total satisfaction degree of eyelid in the observation group was 91.04%, was higher than that in the control group (75.41%,P<0.05).ConclusionThe lateral canthus fusiform skin resection for correction of lower eyelid entropion and the short-term outcome of Wheeler were the same, but the recurrence rate is lower and the long-term effect is better, and the satisfaction of the patients after the operation was higher. It is worth popularizing in clinic.