摘要
目的探讨眼睑部分缝合术治疗眼睑闭合不全的临床疗效。方法5例眼睑闭合不全患者,均采用眼睑部分缝合术治疗。比较患者手术前后眼睑提肌、眼轮匝肌、眼球运动功能评分,上下眼睑距离、眼睑肌力等级,角膜上皮修复指标,各时间疼痛程度,分析术后不良事件与并发症发生情况。结果手术后,患者眼睑提肌功能评分(2.41±0.22)分、眼轮匝肌功能评分(1.60±0.16)分、眼球运动功能评分(6.17±0.45)分均高于手术前的(1.02±0.13)、(0.87±0.12)、(2.04±0.23)分,差异具有统计学意义(P<0.05)。手术后,患者上下眼睑距离(1.48±0.18)mm短于手术前的(3.07±0.32)mm,眼睑肌力等级(3.45±0.32)级高于手术前的(1.87±0.19)级,差异具有统计学意义(P<0.05)。手术后,患者泪膜破裂时间(BUT)(7.45±0.76)s长于手术前的(3.81±0.42)s,角膜荧光素染色(FL)评分(1.30±0.21)分低于手术前的(5.04±0.47)分,差异具有统计学意义(P<0.05)。手术后1、3、7 d,患者视觉模拟评分法(VAS)评分均低于手术前,差异具有统计学意义(P<0.05);围手术期,患者VAS评分呈持续性降低趋势,比较差异具有统计学意义(P<0.05)。5例患者均顺利完成手术治疗,术后角膜上皮均得到修复好转,未出现睑缘成角畸形等并发症,未出现异常出血反应,预后结局良好。结论采用眼睑部分缝合术治疗眼睑闭合不全的效果显著,可有效改善患者眼睑功能,提高其眼睑肌力,促进角膜上皮修复,持续性降低患者术后疼痛程度,且基本无手术相关风险事件发生,值得推广应用。
Objective To discuss the clinical efficacy of partial tarsorrhaphy in the treatment of lagophthalmos.Methods All 5 cases of lagophthalmos were treated with partial tarsorrhaphy.The score of eyelid levator function,orbicularis oculi muscle function and oculomotor function,upper and lower eyelid distance,eyelid muscle strength grading,corneal epithelial repair index before and after surgery and pain level at different time points were compared after surgery,and the incidence of adverse events and complications were analyzed.Results After surgery,the eyelid levator function score was(2.41±0.22)points,the orbicularis oculi muscle function score was(1.60±0.16)points and the oculomotor function score was(6.17±0.45)points,which were higher than those of(1.02±0.13),(0.87±0.12)and(2.04±0.23)points before surgery.The differences were statistically significant(P<0.05).After surgery,the upper and lower eyelid distance of(1.48±0.18)mm was shorter than that of(3.07±0.32)mm before surgery,and the eyelid muscle strength grading of(3.45±0.32)grades was higher than that of(1.87±0.19)grades before surgery.The differences were statistically significant(P<0.05).After surgery,the tear film break-up time(BUT)of(7.45±0.76)s was longer than that of(3.81±0.42)s before surgery,and the corneal fluorescence staining(FL)score of(1.30±0.21)points was lower than that of(5.04±0.47)points before surgery.The differences were statistically significant(P<0.05).At 1,3 and 7 d after surgery,the visual analogue scale(VAS)scores were lower than those before surgery,and the differences were statistically significant(P<0.05).In the perioperative period,the VAS scores of patients showed a continuous decreasing trend,and the difference was statistically significant(P<0.05).All the 5 patients successfully completed the surgical treatment,and the corneal epithelium was repaired and improved after surgery,and no complications such as lid margin angular deformity and no abnormal hemorrhagic reactions,resulting in a favorable prognostic outcome.Conclusion The application of partial tarsorrhaphy in the treatment of lagophthalmos has significant effects,which can effectively improve the eyelid function of patients,improve the eyelid muscle strength,promote corneal epithelial repair,and continuously reduce the postoperative pain of patients,and there are basically no surgical related risk events,which is worthy of promotion and application.
作者
李达佑
黄乔玫
赖江峰
徐洪旺
LI Da-you;HUANG Qiao-mei;LAI Jiang-feng(Meizhou People's Hospital,Meizhou 514000,China)
出处
《中国实用医药》
2023年第22期60-63,共4页
China Practical Medicine
基金
广东省梅州市医药卫生科研课题项目(项目编号:2020-B-4)。
