结膜恶性黑色素瘤的手术治疗  

Surgical Therapies for Malignant Melanoma of Eyelid Conjunctiva

作　　者：郭波[1] 马可[1] 刘绮[1] 

机构地区：[1]四川大学华西医院眼科,成都610041

出　　处：《华西医学》2010年第11期2043-2045,共3页West China Medical Journal

摘　　要：目的探讨结膜恶性黑色素瘤的手术治疗方法。方法 1997年1月-2007年1月收治结膜恶性黑色素瘤48例,均为单眼。肿瘤范围:<1/3眼睑长度及结膜14例,>1/3眼睑长度,部分穹隆结膜受累19例,上下眼睑及内外眦大部分结膜受累者15例。采用单纯肿瘤切除术、单纯肿瘤切除联合液氮冷冻治疗、眼眶内容物剜除术3种治疗方法。结果所有患者均经病理学证实为结膜恶性黑色素瘤。术后48例进行9个月～5年随访,15例眶内容物剜除术,3例死于肺及颅脑转移;14例单纯扩大肿瘤切除联合液氮冷冻治疗,2例死于肝转移;19例单纯扩大肿瘤切除术,6例分别死于肝、肺及颅脑转移。结论早期诊断并选择积极有效的手术治疗是提高患者生存率,改善生存质量的重要手段。手术切除联合液氮冷冻法可有效降低肿瘤复发,避免影响患者视觉质量和外观,是治疗结膜恶性黑色素瘤的一种有效方法。Objective To investigate the surgical therapeutics for malignant melanoma of eyelid conjunctiva. Methods A total of 48patients with monocular malignant melanoma of eyelid conjunctiva from January 1997to January 2007were collected.The scope of the melanoma involved1/3eyelid length and conjunctiva in 14,1/3 eyelid length and part of conjunctival formix in 19,and upper and lower eyelid and most of the conjunctiva of medial and lateral canthus in 15.Eye socket exenteration,tumor resection combine with eyelid reconstruction,tumor resection were used.Results All of the patients were diagnosed as malignant melanoma of eyelid conjunctiva by pathological examination.The follow-up period was 9months-5years.Among the 15patients who had undergone eye socket exenteration,3died.Among the 14patients who had undergone expand tumor resection combine with liquid nitrogen frozen,2died.Among the 19patients who had undergone tumor resection combine with eyelid reconstruction,6died. Conclusion Tumor resection combine with liquid nitrogen frozen is effective on malignant melanoma of eyelid conjunctiva.

关 键 词：结膜 恶性黑色素瘤 手术 

分 类 号：R739.7[医药卫生—肿瘤]