McGregor术式修复外伤后眼睑缺损的效果观察

Efficacy of McGregor procedure in repairing traumatic eyelid defect

摘要:

目的 探讨McGregor术式修复外伤后眼睑缺损效果。方法 选取2019年1月—2021年6月四川省人民医院温江医院和宜宾市第一人民医院收治的84例外伤后眼睑缺损患者作为研究对象。将患者分为对照组和研究组，每组42例。两组患者采用外眦颞侧反向半圆形肌皮瓣进行旋转滑行治疗，对照组患者采取Tenzel术式修复，研究组患者采取McGregor术式修复。术后随访6个月，记录两组手术时间、术中出血量，统计两组患者手术前后的睑裂状况，对比两组眼睑缺损修复美学效果，对比两组患者手术前后的眼表功能状态，统计两组术后并发症发生情况。结果 两组患者手术时间、术中出血量比较，差异无统计学意义（P >0.05）。两组患者手术前后睑裂长度、睑裂高度的差值比较，差异无统计学意义（P >0.05）。两组患者总有效率比较，差异无统计学意义（P >0.05）。两组患者手术前后泪膜破裂时间、Schirmer试验差值比较，差异无统计学意义（P >0.05）。研究组术后总并发症发生率低于对照组（P <0.05）。结论 McGregor术式、Tenzel术式修复外伤后眼睑中度缺损效果相当，均可有效恢复患者眼睑结构及形态，但McGregor术式在安全性方面具有一定优势。

Abstract:

Objective To investigate the efficacy of McGregor procedure in repairing traumatic eyelid defects.Methods Eighty-four patients with traumatic eyelid defects who were treated in Wenjiang Hospital of Sichuan Provincial People's Hospital and The First People's Hospital of Yibin from January 2019 to June 2021 were selected and divided into control group and study group, with 42 cases in each group. Both groups were treated with lateral canthal and temporal reverse semicircular myocutaneous flaps, while Tenzel and McGregor surgical approaches were adopted in the control group and the study group, respectively. Patients were followed up for 6 months after the operation. The operative duration, intraoperative blood loss, and the conditions of palpebral fissures before and after the surgery were recorded in both groups. The aesthetic effects of eyelid defect repair and the ocular surface function before and after the surgery were compared between the groups. The incidence of postoperative complications in the two groups was recorded.Results There was no significant difference in the operative duration and intraoperative blood loss between the two groups (P > 0.05). The differences of the length and height of the palpebral fissures before and after the surgery were not different between the two groups (P > 0.05). There was no significant difference in the overall effective rate between the two groups (P > 0.05). Besides, the differences of tear film breakup time and the result of the Schirmer's test before and after the surgery were also not different between the two groups (P > 0.05). However, the overall incidence of postoperative complications in the study group was lower than that in the control group (P < 0.05).Conclusions McGregor procedure and Tenzel procedure are comparable in the efficacy of repairing moderate eyelid defects due to trauma, and both of them can effectively restore the eyelid structure of patients. Nevertheless, McGregor procedure outperforms the Tenzel procedure in terms of safety.