眼轮匝肌复合瓣结合上睑皮肤松弛矫正术修复较大面积睑黄瘤术后缺损效果观察

目的 探讨眼轮匝肌复合瓣结合上睑皮肤松弛矫正术修复较大面积睑黄瘤术后缺损的效果。 方法 选取较大面积睑黄瘤术后缺损患者92例，依照随机数表法分为观察组和对照组，每组46例。对照组采用单纯手术切除缝合，观察组采用眼轮匝肌复合瓣结合上睑皮肤松弛矫正术修复。比较2组手术时间、肉芽生长时间、治愈时间，残留瘤体评分、凹陷瘢痕评分和色素异常评分，美容效果以及复发率和并发症发生率。 结果 2组手术时间比较差异均无统计学意义（P＞0.05），观察组肉芽生长时间、治愈时间均短于对照组（P＜0.05）；术后1个月2组残留瘤体评分、凹陷瘢痕评分、色素异常评分及综合评分比较，差异均无统计学意义（P＞0.05），术后6个月，2组残留瘤体评分、凹陷瘢痕评分、色素异常评分及综合评分均降低（P＜0.05），且观察组更低（P＜0.05）；观察组和对照组优良率分别为92.00%和80.52%，观察组的优良率高于对照组（P＜0.05）；2组复发率和并发症发生率比较差异均无统计学意义（P＞0.05）。 结论 眼轮匝肌复合瓣结合上睑皮肤松弛矫正术修复较大面积睑黄瘤术后缺损患者，能够缩短康复时间，提高美容效果，安全可靠。

Observation on the effect of orbicularis oculi muscle compound flap combined with correction of upper eyelid skin laxity in repairing large-area defect after surgery for eyelid xanthoma

Objective To explore the effect of orbicularis oculi muscle compound flap combined with correction of upper eyelid skin laxity in repairing large-area defect after surgery for eyelid xanthoma.Methods A total of 92 patients with large-area defect after surgery for eyelid xanthoma were selected and divided into observation group(n=46) and control group(n=46) according to the random number table method. The control group was surgically resected and sutured, and the observation group was treated with the orbicularis oculi muscle compound flap combined with correction of upper eyelid skin laxity. The duration of operation, granulation growth time, healing time, residual tumor score, depressed scar score, and score of pigment abnormalities, cosmetic effect, recurrence rate and complication rate were compared between two groups.Results There was no statistically significant difference in duration of operation between two groups(P＞0.05), and the granulation growth time and healing time of the observation group were shorter than those of the control group(P＜0.05). There was no significant difference in residual tumor score, depressed scar score, score of pigment abnormalities and comprehensive score in the two groups at one month after surgery(P＞0.05). At 6 months after operation, the residual tumor scores, depressed scar scores, score of pigment abnormalities and comprehensive scores of the two groups decreased(P＜0.05), which were lower in the observation group(P＜0.05). The excellent and good rates of observation group was 92.00%, which was higher than that(80.52%) in control group(P＜0.05). There was no statistically significant difference in the recurrence rate and complication rate between two groups(P＞0.05).Conclusion The orbicularis oculi muscle compound flap combined with correction of upper eyelid skin laxity can repair large-area defect of patients after surgery for eyelid xanthoma, which can shorten the recovery time, and improve the cosmetic effect, with good safety and reliability.