水平牵引治疗重度退行性下睑外翻的临床观察

Qin Xiao, Yu-ling Bai, Tian-zi Zhang, Zhan-jun Lu
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The location of the lower lacrimal gland, the location of the lower eyelid, the overflow of tears, foreign body sensation and conjunctival congestion after surgery were observed. \n \n \nResults \nThe treatment group of 23 cases (34 eyes) of lower eyelid ectropion correction in 21 days, 2 cases (2 eyes) on the seventh day after surgery for lacrimal punctum ectropion underwent medial fusiform conjunctival resection, postoperative lower eyelid function improved, foreign body sensation, epiphora symptoms subsided. The control group of 23 cases (34 eyes) of lower eyelid ectropion in 21 days was corrected in 14 cases (21 eyes), 5 cases (7 eyes) of lower eyelid function improved, palpebral margin irregular, corneal irritation and affect the appearance of 4 cases (6 eyes) to open and close the lower eyelid could not close to the ocular surface. There was no significant difference between the two groups (P >0.05). 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摘要

目的观察外眦水平伸展术治疗重度退行性下睑外翻的临床效果。方法回顾性分析临床病例;将46例(68眼)退行性眼睑患者按入院顺序随机分为治疗组和对照组,每组23例(34眼)。治疗组行眦外侧水平拉扯手术,对照组行睑下水平切除,下睑根据位置缩短眦外侧韧带长度。观察术后下泪腺位置、下眼睑位置、溢泪情况、异物感及结膜充血情况。结果治疗组23例(34眼)下睑外翻术后21天矫正,2例(2眼)泪点外翻术后第7天行内侧梭状结膜切除术,术后下睑功能改善,异物感、上睑症状消退。对照组23例(34眼)下眼睑外翻21天内矫正14例(21眼),5例(7眼)下眼睑功能改善,睑缘不规则,角膜刺激及影响外观4例(6眼)下眼睑开合不能靠近眼表。两组间差异无统计学意义(P >0.05)。两组患者术后下泪斑及眼睑位置比较,差异均无统计学意义(P >0.05)。泪溢、异物感、结膜充血差异有统计学意义(P <0.05)。结论采用外眦水平伸展术治疗退行性外翻能更有针对性地解决解剖学的首要问题,创伤小,伤口愈合快,不造成眼睑缺损,改善颜面美观。关键词:退行性外翻;外眼角水平伸展;临床观察
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Clinical observation on horizontal traction in the treatment of severe degenerative lower eyelid ectropion
Objective To observe the clinical effect of horizontal stretch of external canthus in the treatment of severe degenerative lower eyelid ectropion. Methods A retrospective clinical case study; 46 cases (68 eyes) of degenerative eyelid were randomly divided into treatment group and control group according to admission order, each for 23 cases (34 eyes). The treatment group underwent lateral canthal level pull operation, the control group underwent resection under the eyelid level, lower eyelid surgery according to the position of shortened lateral canthal ligament length. The location of the lower lacrimal gland, the location of the lower eyelid, the overflow of tears, foreign body sensation and conjunctival congestion after surgery were observed. Results The treatment group of 23 cases (34 eyes) of lower eyelid ectropion correction in 21 days, 2 cases (2 eyes) on the seventh day after surgery for lacrimal punctum ectropion underwent medial fusiform conjunctival resection, postoperative lower eyelid function improved, foreign body sensation, epiphora symptoms subsided. The control group of 23 cases (34 eyes) of lower eyelid ectropion in 21 days was corrected in 14 cases (21 eyes), 5 cases (7 eyes) of lower eyelid function improved, palpebral margin irregular, corneal irritation and affect the appearance of 4 cases (6 eyes) to open and close the lower eyelid could not close to the ocular surface. There was no significant difference between the two groups (P >0.05). There was no significant difference in the lower lacrimal spot and eyelid position between the two groups after surgery: P >0.05. There were significant differences in lacrimal overflow, foreign body sensation and conjunctival congestion P <0.05. Conclusions Adopting the horizontal stretch of external canthus in the treatment of degenerative ectropion would be aimed more pertinently at the primary problem of anatomy, with the advantage of less trauma and quick wound healing, without causing the eyelid defects and improving facial appearance. Key words: Degenerative ectropion; Horizontal stretch of external Canthus; Clinical observation
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