移植技术联合重睑成形术在上睑缺损畸形美容性修复中的应用［摘耍］日的：探讨利用移植技术联合重脸成形术修复上脸缺损的方法及临床意义。方法：根据上睑缺损程度、部位，选择眼睑皮肤移植、眼轮吨肌肌皮瓣以及扩张超薄皮瓣等方法进行修复，同时行重睑成形术。结果：20例患者中，利用対侧上睑皮肤游离移植修复上睑缺损5例，利用眼轮匝肌肌皮瓣旋转、推进修复上睑皮肤缺损10例，利用扩张超薄皮瓣修复上脸皮肤缺损5例。术后无皮瓣坏死、无供区继发畸形等并发症，随访3~18个月，功能恢复完全，形态满意，双侧眼睑睁、闭眼时的动态表情一致。结论：对于外伤后瘢痕或良性肿瘤切除后所致的上睑缺损畸形，利用重睑成形技术的修复，实现了上睑功能和神态的同时恢复，且不遗留供区畸形，是一种设计合理、灵活、具有个性化的美容性修复方法。［关键词］上睑缺损；美容性修复；重睑成形术［中图分类号JR622［文献标志码］A［文章编号J1008-6455(2015)12-0026-04TheapplicationoftransplanttechniquescombinedwithdoubleeyelidtechnologyforuppereyeliddefectreconstructionYANGSi-fenl,MATing-ting2,XUWeil,WANGChun-meil(1.DepartmentofPlasticandAestheticSurgery,DongguanKanghuaHospital,Dongguan523080,Guangdong,China；2.DepartmentofBreastSurgery,QiluHospitalofShandongUniversity,Jinan250012,Shandong,China)Abstract:ObjectiveToinvestigatetheuseoftransplanttechniquescombinedwithdoubleeyelidtechnologyforuppereyeliddefectreconstructionandthesignificanceofclinicalapplication・MethodsAccordingtothedegreeandlocationofuppereyeliddefect,selectedthemethodsofeyelidskingrafting,localflaps,orbicularisoculimyocutancousflapsoroxpandodsuper-thinflaps,andcombinedwithdoubleeyelidsurgerysimultaneously.ResuIts20patientswithdifferentkindsofuppereyeliddefectunderwentthismethodoftreatment,5casesforusingofthecontralateraluppereyelidskingraft,10casesforusingoftheorbicularisoculimyocutaneousflapsrotatingoradvancing,and5casesforusingofexpandedsuper-thinflap.Followupfor3to18monthspostoperativelyshowedtherewasnoflapnecrosis,secondarydeformityandotherpostoperativecomplicationoccurred,thefunctionrecoveredsatisfactoryandthebilateraleyelidsplayedtheexpressionconsistently.ConclusionTorestoretheuppereyeliddefectaftertraumaticscarorbenigntumorsresection,theuseofdoubleeyelidtechnologycanachievebothfunctionandappearancerecovery,andnodonorsitemalformationleft,thisisacosmeticreconstructivemethodwithrationalization,flexibilityandpersonalization.Keywords：uppereyelid；repair；transplanttechniques；doubleeyelidsurgery良性肿瘤或外伤后瘢痕切除所致的上脸缺损畸形，不仅需耍恢复其眼睑的功能和形态，能否完美的再现睁、闭眼时的动态表情则更是整形外科医生具有挑战性的任务。上睑缺损畸形的修复材料应根据上睑解剖结构的特殊性，选择色泽、质地、厚度最相近的组织[1-2]o本研究自2002-2014年利用移植技术联合重脸成形术，根据上脸的缺损部位、缺损程度，选择眼脸全层皮肤移植、眼轮匝肌肌皮瓣以及邻近的扩张皮瓣，对外伤、肿瘤切除等原因所致上睑缺损畸形的20例患者进行个性化的设计，实现了上睑功能和神态的同时恢复，为上睑缺损畸形的美容性修复提供了新的思路。1资料和方法1.1临床资料：良性肿瘤切除后上脸皮肤缺损12例（包括分裂痣3例、上睑黑痣5例、睑黄瘤4例）、瘢痕切除后上睑缺损8例。共20例，24个部位，单眼16例，双眼4例。其中男性6例，女性14例，年龄6〜52岁，平均32.5岁。随访时间为3~18个月。1.2手术方法1.2.1健侧上睑皮肤游离移植+双侧重睑成形术：健侧行常规重睑成形术，根据患侧缺损面积及健侧皮肤松弛程度确定需切取的健侧上脸皮肤面积大小，游离移植于患侧创面，其中1例因术后外形欠佳行患侧II期重睑修整术。1.2.2眼轮匝肌肌皮瓣局部转移+双侧重睑成形术：利用重睑成形术时需去除的皮肤及眼...