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  [摘要]目的：观察中老年上睑皮肤松弛矫正术的临床效果。方法：根据上睑皮肤松弛程度与厚度不同单纯行提眉术、提切眉术、重睑术或同期行提眉术+重睑术或提切眉术+重睑术。结果：本组146例，87 例获得较长期随访，随访6个月～2 年，均获满意效果。结论：上睑皮肤松弛矫正手术创伤小，操作简单，恢复快，是中老年面部年轻化，改善容貌，增强自信心，提高生活质量的理想手术。

 [关键词]中老年；上睑松弛；重睑术；提切眉术；效果

 [中图分类号]R622[文献标识码]A[文章编号]1008-6455(2011)10-1533-02

 Observations of the skin chalasis of upper eyelid correction

 in the middle-aged and elderly people

 NIU Jin-bao,LI Gao-zhong,ZHOU Kai-hua

 (Department of Ophthalmology,Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China)

 Abstract:ObjectiveTo observe the clinical effect of the skin chalasis of upper eyelid correction in the middle-aged and elderly people.MethodsAccording to the degrees and thicknesses of the skin chalasis of the upper eyelid, simple brow lifting, brow lifting and shaping, double eyelid operation or brow lifting + double eyelid operation/brow lifting and shaping + double eyelid operation are performed simultaneously.ResultsThere were 146 cases in the group, 87 of whom were followed up postoperatively for 6 to 24 months. Prognosis was judged by all to be excellent.ConclusionHaving small trauma, easy to perform and quick to recover,the skin chalasis of upper eyelid correction is an ideal operation for the middle-aged and elderly people to make them look younger, improve their appearance,enhance their confidence and raise their living qualities.

 Key words: middle aged and elderly people; double eyelid operation; brow lifting and shaping; effect

 随着人们生活水平的提高，对美的追求不再是年轻人的专利，越来越多的中老年人更新思想观念，希望自己容貌年轻，因而要求实施上睑松弛矫正手术者越来越多。2000 年1月以来，笔者采用重睑术、提切眉术或提切眉术同期重睑术矫正上睑松弛，取得满意效果，现报道如下。

 1临床资料

 本组共146例，均为女性，年龄38～65 岁。重睑术52例、提眉术51例、提切眉术29例、提眉术+重睑术14例，其中61例同期行下睑袋整复术或下睑松弛矫正术。所有患者术前均有不同程度的上睑皮肤松弛, 鱼尾纹加深，部分伴有不良文眉或眉下垂。

 2手术方法

 2.1切口设计

 2.1.1 提切眉术的设计：患者端坐位，双眼平视，观察其眉、眼形态，上睑松弛程度，鱼尾纹状况，切口设计应视患者具体情况而定，整体考虑，灵活掌握，可设计为眉上或眉下全长切口、或眉上或眉下中外侧切口，力求对自身眉毛能少切者尽量少切，以最大限度保留自身眉毛，达到理想矫正为原则[1]。

 2.1.2 重睑成形术的设计：患者平卧位，轻闭双眼，距睑缘6～7mm设计重睑线，然后用无齿镊自重睑线向上分内、中、外三点夹持上睑皮肤并做标记，然后将这些点以弧线连接起来, 形成上切口线。上下两线在内、外侧交汇，确定需切除松弛皮肤的宽度[2]。

 2.2手术方法

 2.2.1提切眉术：沿设计线切开皮肤全层，深达皮下，切除不良文眉及多余皮肤。切口方向须与眉毛生长方向一致，以减少毛囊破坏。对于眉下垂及上睑松弛或有额纹、鱼尾纹者将切口下缘的真皮- 皮下组织交界处固定在切口上缘相应的骨膜上。用5-0 可吸收缝线间断缝合皮下，8-0 尼龙线间断缝合皮肤。眉整形术常常切口上下缘组织厚薄不一，缝合时注意勿出现阶梯感。眉下切口行皮下缝合时，切口下缘的眼轮匝肌不要多挂，且上下缘应准确对位缝合，以免出现上睑皱褶[1]。

 2.3.2 重睑成形术：沿重睑线及上切口线分别切开皮肤全层 ......