特发性上睑下垂的临床观察

《特发性上睑下垂的临床观察》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、特发性上睑下乖的临床观察作者：徐东强，洪玲，肖艳霞单位：430070)中国湖北省武汉市，广州军区武汉总医院眼科【摘要】目的：观察特发性上脸下垂的临床特点及手术治疗效果。方法：不明原因上睑下垂患者19例25眼,W12〜72(平均35.4)岁,均病因不明,提上脸肌力9〜15(平均11.3)mm;均在局部麻醉下行提上睑肌缩短术，术中观察提上睑肌腱膜的解剖情况;术中将患侧睑缘上提至合适水平。结杲：术中发现5例患者的提上睑肌腱膜变薄，16例提上睑肌腱膜与上睑板Z间附着松弛。随访Imo〜la,16例(84%)矫正满意(单眼患者双眼睑缘完全等高或相差limn以内;双眼患者上脸缘位于

2、上角膜缘下1〜2mm,且双眼高度差在1mm以内),3例(16%)欠佳(双眼上脸缘位置相差约2mm)o所有病例术后外观均鮫术前有改善或明显改善。结论：特发性上睑卜垂佔计与提上睑肌腱膜附着松弛或腱膜变薄有关。提上睑肌缩短术可较满意地改善外观。【关键词】腱膜性睑卞垂;提上睑肌缩短术;特发性ClinicalobservationofidiopathicptosisDongQiangXu,LingHong,YanXiaXiaoDepartmentofOphthalmology,WuhanGeneralHospitalofGuangzhouCommand,Wuhan43(X)70

3、,HubeiProvince,ChinaAbstractAIM:Toobservetheclinicalcharacteristicsandtreatmenteffectivenessofidiopathicptosis.METHODS:Nineteencases(25eyes)withidiopathicptosisagedfrom12to72years(average35.4)hadunknownetiology,andthemusclestrengthofapertoroculiofthemwas9^15mm(average11.3).Allcasesunder

4、wentapertoroculishorteningunderlocalanesthesia.Anatomyofapertoroculiaponeurosiswasobserved,andlimbuspalpebralisofaffectedsidewasliftedtoappropriatepositionintraoperatively.RESULTS:Duringtheoperations,wefoundthinnedaponeurosisin5casesandflaccidaadhesionofapertoroculiaponeurosistosuperior

5、tarsusin16cases.After1monthto1yearfollowup,16cases(84%)gotsatisfactoryeffects(equalheightordifferencelessthan1mmoftwoupperlidmarginsforsingleeyepatients;Fortwoeyespatients,twoupperlidmarginswere1〜2mmbelowtheuppercornealedges,anddifferenceinheightwaswithinlmin).3cases(16%)gotunsatisfacto

6、ryeffects(thedistancebetweenupperlidmarginsofthetwoeyeswasabout2mm).Allcaseshadbetterorobviouslybetteraspectsthanthatbeforeoperation.CONCLUSION:Idiopathicptosisseemstoberelevanttotheflabbyadhesionofthelevatormuscleofuppereyelidaponeurosisorattenuationofaponeurosis.Levatormuscleofupperey

7、elidshorteningcouldimprovetheaspectssatisfactorily.KEYWORDS:aponeuroticptosisofupperlid;levatorrecessionsurgery;idiopathic0引言腱膜性上脸下垂是一种后天性上险下垂，发生率不高，但也不罕见。其主要临床表现为上睑下垂，重睑增宽，部分病例伴上眶区凹陷，提上睑肌功能好或较好。现在比较统-的观点认为该病是由于提上睑肌腱膜缺损造成的。其发病原因多种多样，有外伤、供源性、配戴隐形眼镜、眼部疾病及自发性等原因。有关前儿种病因的上睑下垂在近儿年的文