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目的探讨急诊眼睑全层裂伤的病因、临床特点、手术方法及效果。设计回顾性病例系列。研究对象北京同仁医院眼科急诊的60例(60眼)眼睑全层裂伤患者。方法询问病史,详细眼科检查。应用垂直褥式、水平褥式和三缝线缝合法修复眼睑全层裂伤。对伴有泪小管断裂、内外眦韧带离断、眼睑皮肤缺损、眼睑全层缺损、提上睑肌断裂者,还需行泪小管断裂吻合、内外眦韧带复位、提上睑肌断裂缝合复位、皮肤缺损及眼睑缺损修复术。主要指标眼睑形态,眼睑位置,眼睑运动功能,吻合后的泪小管是否通畅。结果眼睑全层裂伤病因主要是车祸伤、外物击伤、坠落伤、动物咬伤。眼睑裂伤多伴有泪小管断裂、内外眦韧带离断、眼睑皮肤及全层缺损、提上睑肌断裂。急诊手术后随访6～12个月,绝大部分患者术后眼睑外观形态、眼睑闭合以及运动恢复良好,38例(95%)泪小管吻合术后保持通畅。结论车祸伤和外物击伤是急诊眼睑全层裂伤的主要原因,及时、正确、细致地手术处理可使大部分眼睑裂伤在Ⅰ期得到良好的修复,同时也为少部分患者Ⅱ期整复做好准备。
Objective To investigate the etiology, clinical features, surgical methods and effects of emergency eyelid full thickness laceration. Design retrospective case series. The study included 60 patients (60 eyes) with eyelid full thickness laceration in Beijing Tongren Hospital. Methods to ask history, detailed eye examination. Application of vertical mattress, horizontal mattress and three suture suture repair eyelid full thickness laceration. Rupture of the canalicular laceration, ligament rupture of the internal and external, eyelid skin defects, eyelid full-thickness defects, mention levator muscle rupture, the need for rupture of the canaliculi anastomosis, internal and external Jia ligament reset, mention levator muscle rupture suture reduction, Skin defects and eyelid defect repair. The main indicators eyelid morphology, eyelid position, eyelid motor function, anastomosis lacrimal duct patency. Results Eyelid full-thickness laceration causes are mainly car accident wounds, foreign body injuries, fall injuries, animal bites. Eyelid laceration associated with tear canal rupture, ligament rupture both inside and outside, eyelid skin and full-thickness defects, mention levator muscle rupture. After emergency operation, the patients were followed up for 6 to 12 months. Most of the patients had good postoperative eyelid appearance, eyelid closure and good motor recovery. 38 cases (95%) of the tracheal anastomosis remained unobstructed. CONCLUSIONS: Traffic accident and wounding are the main causes of full-thickness eyelid laceration. Timely, correct and meticulous surgical treatment can make most of the eyelid laceration get a good repair in stage Ⅰ, and also for a small number of patients in stage Ⅱ Complete restoration ready.