改良额肌瓣悬吊术术中术后并发症分析

目的 探讨改良额肌瓣悬吊术治疗先天性上睑下垂术中术后并发症的发生原因及处理措施.方法 回顾性分析改良额肌瓣悬吊术治疗先天性上睑下垂136例（167眼）的临床资料.结果 术中并发症14眼,发生率为8.38％,其中出血影响操作10眼（5.98％）,眶脂肪脱出3眼（1.80％）,额肌瓣撕裂1眼（0.60％）.术后并发症12眼,发生率7.19％,其中矫正过度5眼（2.99％）,矫正不足3眼（1.80％）,缝线反应致上睑瘢痕1眼（0.60％）,睑缘位置不自然1眼（0.60％）,上睑肿胀1眼（0.60％）,角膜上皮脱落1眼（0.60％）.经过施行相应的处理措施,并发症均治愈.结论 术前全面检查、提高手术技巧、术中精细操作、术后及时处理是减少改良额肌瓣悬吊术并发症的关键.

Clinical analysis of complications of modified frontal muscle flap suspension

Objective To investigate the causes and treatment of complications after modified frontal muscle flap suspension for congenital ptosis.Methods This was a retrospective analysis of 167 eyes of 136 patients with congenital ptosis,who underwent modified frontal muscle flap suspension.Results Complications during operation occurred in 14 eyes（8.38%）,including hemorrhage in 10 eyes （5.98%）,prolaps of fat in orbital cavity in 3 eyes （1.80%）,frontal muscle tearing in 1 eye （0.60%）.The complications after operation occurred in 12 eyes（7.19%）,including overcorrection in 5 eyes （2.99%）,undercorrection in 3 eyes （1.80%）,suture reaction leading to upper eyelid scar in 1 eye （0.60%）,unsmooth edge of upper-eyelid in 1 eye （0.60%）,swelling in upper eyelid in 1 eye （0.60%）,corneal epithelial defects in 1 eye （0.60%）.Conclusion The adequate preoperative examination,improving surgical skills,careful operation,and appropriate disposal timely after surgery are important to prevent and avoid comolications of modified frontal muscle flap suspension.