居民施行的功能性上睑成形术的安全性和疗效。
Safety and Efficacy of Resident-Performed Functional Upper Eyelid Blepharoplasty.
机构信息
Department of Ophthalmology and Vision Science, University of California Davis Health.
University of California Davis School of Medicine, Sacramento, California, U.S.A.
出版信息
Ophthalmic Plast Reconstr Surg. 2019 Nov/Dec;35(6):578-580. doi: 10.1097/IOP.0000000000001395.
PURPOSE
To determine the safety and efficacy of resident-performed functional upper eyelid blepharoplasty.
METHODS
The authors retrospectively looked at functional upper eyelid blepharoplasty surgery performed on 836 eyes of 448 patients under the supervision of one oculoplastic surgery attending at the University of California Davis Eye Center from January 1, 2013, to December 31, 2017. The primary surgeon was a resident on 427 eyes and was an attending on 409 eyes. Patients (73.5%) were female, and the mean age was 66.0 ± 10.0. All patients had at least 2 postoperative visits, and eyes that underwent other concurrent upper eyelid or brow procedures were excluded. The authors looked at major and minor complications, percentage of initially dissatisfied patients, and percentage of cases that required a revision procedure within 6 months. Chi-square tests were used for statistical analysis.
RESULTS
There were no major complications in either group. There was no difference in the rate of minor complications (10.8% vs. 7.6%, p = 0.11), percentage of patients who were initially dissatisfied with the procedure (3.5% vs. 2.0%, p = 0.17), or percentage of patients requiring a revision procedure (5.2% vs. 3.2%, p = 0.15). The most common minor complications were inclusion cysts (45, 5.4%), wound dehiscence (9, 1.1%), and hypertrophic scars (9, 1.1%), and the most common revision procedures were removal of inclusion cyst(s) (17, 2.0%) and suturing or placement of topical skin adhesive for wound dehiscence (9, 1.1%).
CONCLUSIONS
Ophthalmology residents can perform functional upper eyelid blepharoplasty safely and effectively under the supervision of an attending physician.Resident-performed functional upper eyelid blepharoplasty under the direct supervision of an attending is a safe and effective procedure with similar complication rate, number of revision procedures, and patient satisfaction to attending-performed functional upper eyelid blepharoplasty.
目的
评估住院医师施行的功能性上睑成形术的安全性和疗效。
方法
作者回顾性分析了 2013 年 1 月 1 日至 2017 年 12 月 31 日期间，在加利福尼亚大学戴维斯眼科中心，一位眼整形手术主治医生在监督下，由一位住院医师对 448 例患者的 836 只眼施行的功能性上睑成形术。在 427 只眼中，初级手术医生为住院医师，在 409 只眼中，手术医生为主治医生。患者（73.5%）为女性，平均年龄为 66.0±10.0 岁。所有患者均至少接受了 2 次术后随访，且排除了同时施行其他上睑或眉部手术的患者。作者观察了主要和次要并发症、初次不满意的患者比例以及 6 个月内需要再次手术的比例。采用卡方检验进行统计学分析。
结果
两组均未发生重大并发症。两组间的轻微并发症发生率（10.8% vs. 7.6%，p = 0.11）、初次对手术不满意的患者比例（3.5% vs. 2.0%，p = 0.17）或需要再次手术的患者比例（5.2% vs. 3.2%，p = 0.15）无差异。最常见的轻微并发症是包涵囊肿（45 只眼，5.4%）、伤口裂开（9 只眼，1.1%）和增生性瘢痕（9 只眼，1.1%），最常见的再次手术是切除包涵囊肿（17 只眼，2.0%）和缝合或应用局部皮肤黏合剂闭合伤口裂开（9 只眼，1.1%）。
结论
在主治医生的直接监督下，住院医师可以安全有效地施行功能性上睑成形术。在主治医生的直接监督下，由住院医师施行的功能性上睑成形术是一种安全有效的术式，其并发症发生率、再次手术率和患者满意度与主治医生施行的功能性上睑成形术相似。
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