眼睑淀粉样变性的手术治疗及眼睑缺损修复观察  

Surgery management of eyelid amyloidosis and repair of eyelid defect

作　　者：朱惠敏[1] 孙英[1] 范先群[1] 林明[1] 李政康[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：《临床眼科杂志》2009年第5期434-436,共3页Journal of Clinical Ophthalmology

基　　金：上海市重点学科建设项目资助(S30205)

摘　　要：目的观察眼睑(结膜、睑板)淀粉样变性的手术治疗及肿块切除后眼睑缺损修复的临床疗效。方法对13例(15只眼)眼睑淀粉样变性患者进行回顾性分析。所有患者临床表现为眼睑无痛性肿胀肥厚,结膜呈蜡黄色增厚,累及上睑者尚伴有上睑下垂。手术均采用彻底切除肉眼所见淀粉样变性组织,切除物送病理检查,一期修复眼睑后层缺损(游离黏膜片移植、睑板结膜瓣滑行移植或硬腭黏膜移植)及矫正上睑下垂。结果病理诊断符合淀粉样变性。随访时间为6～50个月,其中1只眼因早期手术未完全切除有残留而复发外,其余14只眼未见复发,眼睑外形无畸形。结论眼睑淀粉样变性临床上较少见,可导致眼睑肿胀肥厚、上睑下垂等外观及功能障碍。彻底切除病变组织,同期修复眼睑缺损,对于减少复发、恢复眼睑外形及功能,具有较好的临床效果。Objective To observe the clinical effect of the eyelid amyloidosis by complete excising the lesion and repairing the defect. Methods A retrospective study of 13 cases of eyelid amyloidosis was performed. All patients presented painless swelling of eyelid and the conjunctival lesion＇ s color was yellow. The upper eyelid amyloidosis could cause ptosis. Surgery management consisted of complete exeisional biopsy for the lesions and repair for the posterior layer defect at the same time I free mucus flap, tarso-conjunctival flap or hard palate transplantation）. If necessary, ptosis should be col- lected. Results Histopathological examination accorded with amyloidosis. Follow up from 6 to 50 months, except one patient recued due to incomplete excision, 12 patients had no recurrence and eyelid malformation. Conclusion Eyelid amy- loidosis is an uncommon condition. It causes malformation and dysfunction of eyelids such as swelling and ptosis. This surgery technique has a better clinical effect in reducing recurrence and resuming appearance and function of eyelids.

关 键 词：淀粉样变性 眼睑缺损 手术 

分 类 号：R779.6[医药卫生—眼科]