CAJ | 학술논문

目的探讨3种术式上睑退缩的疗效。方法重睑术后及甲状腺眼病并发上睑退缩患者15例分为A、B、C组,A组5例9只眼采用A型肉毒杆菌毒素注射治疗,B组5例10只眼采用上睑提肌中央腱膜切断术矫正,C组5例9只眼采用上睑提肌和Müller肌(穆勒氏肌)延长术矫正上睑退缩,观察3种术式的疗效。结果 A组注射A型肉毒杆菌毒素72 h后,5例(9眼)上睑退缩外观明显改善,维持4~6个月后恢复至以前未注射时状态；B组上睑提肌中央腱膜切断术,术后睑外形自然,睑闭合自然,其中有2例复发；C组上睑提肌-穆勒氏肌延长术,术后随访3~24个月效果满意,术后无复发和并发症。结论3种治疗上睑退缩的方法对静止期上睑退缩均有效。采用A型肉毒杆菌毒素方法简便,疗效可靠,但持续时间较短,需反复注射；采用上睑提肌中央腱膜切断术操作简单,但不易正确量化且回缩略多；上睑提肌-穆勒氏肌延长术方法较简便,疗效可靠,并发症少。
목적탐토3충술식상검퇴축적료효。방법중검술후급갑상선안병병발상검퇴축환자15례분위A、B、C조,A조5례9지안채용A형육독간균독소주사치료,B조5례10지안채용상검제기중앙건막절단술교정,C조5례9지안채용상검제기화Müller기(목륵씨기)연장술교정상검퇴축,관찰3충술식적료효。결과 A조주사A형육독간균독소72 h후,5례(9안)상검퇴축외관명현개선,유지4~6개월후회복지이전미주사시상태；B조상검제기중앙건막절단술,술후검외형자연,검폐합자연,기중유2례복발；C조상검제기-목륵씨기연장술,술후수방3~24개월효과만의,술후무복발화병발증。결론3충치료상검퇴축적방법대정지기상검퇴축균유효。채용A형육독간균독소방법간편,료효가고,단지속시간교단,수반복주사；채용상검제기중앙건막절단술조작간단,단불역정학양화차회축략다；상검제기-목륵씨기연장술방법교간편,료효가고,병발증소。
objective To explore a reasonable treatment for upper eyelid shrinking. Methods All 15 patients with upper eyelid retrac-tion were divided in group A,group B and group C. Group A with 9 eyes received botulinum toxin type A,group B with 10 eyes were corrected by central aponeurosis disinsertion,group C with 9 eyes upper eyelid were corrected by the lengthening of the levator muscle and Müller's muscle. And the data was summarized and analyzed. Results Five cases (9 eyes) with upper eyelid shrinking obviously were improved 72 h after injecting botulinum toxin type A,but the eyelids returned to previous states 4~6 months later. The shape of postoperative eyelid was good and the eyelids structure was natural in group B,recurrence was in 2 cases. Patients in group C had satisfactory results. And there was no recurrence and complications after 3~24 months of follow-up. Conclusion The three treatments have effect on upper eyelid shrinking at quiescence phase. The method of injecting botulinum toxin type A is simple,with reliable curative effect and short duration,while it was nee-ded repeated injections. The method of central aponeurosis disinsertion is simple but difficult to quantify properly. The lengthening of the leva-tor muscle is not only simple but also with reliable effect and less complications.