全眶周闭眼肌群切除术治疗特发性眼睑痉挛临床分析

目的 探讨全眶周闭眼肌群切除术治疗特发性眼睑痉挛的有效性及安全性。方法 采用全眶周闭眼肌群广泛切除治疗特发性眼睑痉挛,以特发性眼睑痉挛临床分级(EBCG)评价患者眼睑痉挛的严重程度,并以眼睑痉挛残疾指数 (BSDI)作为患者日常生活和工作情况的自评依据。回顾分析2015年7月~2019年11月在我院行全眶周闭眼肌群切除术的18例特发性眼睑痉挛患者术后眼睑痉挛严重程度和日常生活及工作改善程度,并观察术后并发症。结果 在随访期内,所有术眼(36眼)术后EBCG均较术前有不同程度降低,其中完全缓解11眼(30.56%)、明显缓解15眼(41.67%)、部分缓解10眼(27.78%),总有效率达100%。BSDI评分则从术前的(2.73±2.51)分降至(0.24±0.26)分,较术前明显降低(P<0.05)。术后3个月内,所有病例均有不同程度的前额部麻木,3个月后前额部麻木开始逐步减轻,于术后10个月左右基本消退。所有术眼术后早期均有不同程度的眼睑水肿,并于术后半年开始逐步消退,5眼长期存在不同程度的眼睑水肿。眼睑闭合不全3眼、下睑外翻4眼。未见复发病例。结论 全眶周闭眼肌群切除术可以安全、有效治疗特发性眼睑痉挛。

Periorbital protractors myectomy for essential blepharospasm

Objective To evaluate the effectiveness and safety of periorbital protractors myectomy in patients with essential blepharospasm. Methods From July 2015 to November 2019, eighteen Chinese patients underwent periorbital protractors myectomy. Essential Blepharospasm Clinical Grading(EBCG)and Blepharospasm Disability Index (BSDI)were used to evaluate clinical outcomes. The common complications were recorded. Results Of the 18 patients (36 eyes) who underwent protractors myectomy, EBCG was significantly reduced, 11 eyes were cured (30.56%), 15 eyes significantly relieved (41.67%), and 10 eyes partially relieved (27.78%), the effective rate was up to 100%. The mean baseline score of BSDI was 2.73±2.51 before operation, and decreased to 0.24±0.26 after operation, the difference was of statistical significance(P<0.05). The common complications included forehead numbness, eyelid edema, ectropion of lower eyelid and lagophthalmos. No recurrence occurred during the follow-up period. Conclusions Periorbital protractors myectomy is safe and effective for essential blepharospasm.