眼睑恶性肿瘤诊疗中应关注的几个问题  

Highlights in diagnosis and surgical treatment of eyelid malignant tumors

作　　者：范先群[1] 赵莼[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院 眼科,200011

出　　处：《眼科》2008年第6期361-363,共3页Ophthalmology in China

基　　金：上海市科委重点课题资助项目(04JC14041);上海市重点学科建设资助项目(S30205)

摘　　要：眼睑恶性肿瘤发病率较高,临床表现复杂多样,术前难以确诊,针刺活检有助于判断眼睑恶性肿瘤类型,指导手术选择。手术切除是治疗眼睑肿瘤的首要方法,但对手术方法选择和切缘控制等仍存在不同看法。快速病理控制切缘的手术方法(Mohs法)能保证在完整清除肿瘤的前提下,掌握组织的最佳切除量。术中眼组织缺损即期修复是眼睑恶性肿瘤治疗的重要环节,手术医生需具备良好的眼整形外科技术,根据缺损的范围、部位和层次等灵活选用合理的修复方法,才能取得肿瘤根治和眼睑功能重建并举的效果。术后应长期随访,及时发现肿瘤复发情况并积极处理,可明显降低患者的转移率和致死率。Eyelid malignant tumor has relatively high incidence with complex manifestations, easily leading to misdiagnose. Fine-needle aspiration biopsy （FNAB） should be recommended when indicated, considering its validity in determining the type of eyelid tumor pathologically and its contribution to guide surgical treatment. Surgery is the most preferred method in dealing with eyelid malignancy. However, no consensus with regard to surgical options and margins of exeresis has been reached so far. Mohs micrographic surgery（MMS）, which is being increasingly advocated, is the most reliable method of assessing tumor margins by frozen section with both complete removal of tumor and extreme spare of eyelid tissue. Immediate repair of eyelid defect following tumor removal is a key step for which good understanding of oculoplastic techniques is needed. Reconstructive choices for eyelid depend on size, range and location of eydlid defect. Based on these, the curable effect as well as cosmetically satisfactory appearance can be achieved. Postoperative follow up is necessary and life-long follow up may even be considered to be routinely carried out in order to discern recurrence or metastasis upon onset of it.

关 键 词：眼睑恶性肿瘤 外科学 眼睑成形术 治疗方法 

分 类 号：R739.7[医药卫生—肿瘤]