中老年人上睑皮肤松弛分型和术式选择的临床研究

目的:探讨中老年人上睑皮肤松弛的分型和手术方法的临床效果。方法:依据上睑皮肤松弛程度、上睑臃肿、眉与上睑缘间距(正常为2cm)、眉下垂的程度等进行分型。分为三型,I型(眉无下垂型):上睑皮肤轻度松弛下垂,重睑线变窄,眉与上睑缘间距小于正常或正常;II型(眉下垂型):上睑皮肤松弛,外1/3下垂,眉与上睑缘间距大于正常,眉轻度下垂;III型(眉明显下垂):上睑皮肤松弛下垂明显、臃肿,眉与上睑缘间距明显小于正常,变窄,外1/3遮盖瞳孔,影响视线。分别选择眉上缘切口或眉下缘切口,以及重睑切口,分别去除眉上缘或眉下缘松弛下垂皮肤,固定眉脂肪垫,悬吊眼轮匝肌,手术治疗上睑皮肤松弛。结果:本组患者均在一周左右逐渐恢复,重睑线及眼睑外形良好。68例术后随访3个月～3年,视物清晰,切口瘢痕不明显,外形自然,效果均满意。结论:对上睑皮肤松弛者,应依据松弛程度,按不同分型,选择不同的术式,会产生不同的临床效果。

Clinical study on the classification and treatment of the loose upper eyelid

Objective To investigate the loose upper eyelid skin in classification and treatment.Methods Three types are classified by brow position,upper eyelid fat,and the width of upper eyelid skin.I(no ptosis): right brow position,light relaxation of upper eyelid skin,and narrow double eyelid;II(ptosis): 1/3 eyebrow ptosis and narrow eyelid;III(triangle eyes): fat upper eyelid skin,significant hypertrophy and relaxation,severely covering vision.To remove excess fat tissue,lift orbicularis muscle,and treat on loose upper eyelid skin,the operations can be adopted by excising upper edge of eyebrow,lower edge of eyebrow and double eyelid.Results 50 cases are satisfied with nature double eyelid one week after operation.Conclusion The differenet treatments and effects are reflected according to the various classification of loose upper eyelid skin.