颞侧眼睑分裂痣Ⅰ期手术临床治疗  

Temporal divided naevus of the eyelid ： one-stage surgical treatment

作　　者：周祁[1] 胡向松[1] 毕燕龙[1] 

机构地区：[1]同济大学附属同济医院眼科,上海200065

出　　处：《中华医学美学美容杂志》2011年第6期414-416,共3页Chinese Journal of Medical Aesthetics and Cosmetology

基　　金：上海市高校优秀青年教师资助项目（编号：1500144019）

摘　　要：目的探讨颞侧眼睑分裂痣Ⅰ期手术的临床疗效。方法术中先完全切除患侧浸及皮肤、睑缘及睑板的痣组织，并制作共蒂双斧状皮瓣。根据病变切除范围的大小及皮瓣转位后的张力，做相应睑缘缩短。通过睑板下移做睑缘重建。根据睑板切除的高度计算上睑提肌-Muller肌的延长量。皮瓣转位覆盖缺损的眼睑皮肤，在低张力下缝合。结果8例8只眼均为单侧，术后经22个月至3年的随访，患眼睑缘位置正常，皮肤无明显色差，瘢痕不明显，患眼睑裂大小及上下睑活动良好，未见痣复发。结论针对较大的颞侧眼睑分裂痣，治疗中除需考虑皮瓣修复的设计外，睑板缩短、睑缘重建和上睑提肌力量的均衡也同样不可忽视。Objective To evaluate the clinical effects of one stage treatment for the temporal divided naevus of the eyelid. Methods The divided naevus infiltrated to the skin, eyelid margin and tarsal plate was completely resected, and co-pedicle double hatchet skin flaps were trimmed. According to the areas of the defects and tension of the sliding flaps, shortening of the eyelids＇ margins were undertaken. The upper eyelid margin was reconstructed by the downward shift of the tarsal plate. According to the resected height of the tarsal plate, the extended length of the tevator aponeurosis- Muller＇s muscle compound was measured. Skin trimming was unnecessary and the incisions were usually closed under no tensions. Results Eight eyelids of eight cases were treated by this method and followed up for 22 months to 3 years, the eyelids＇ margins were all in normal positions, without skin chromatic aberration and obvious scar formation. The size of the palpebral fissure and eyelids＇ move- ment were normal and no recurrence happened in all patients. Conclusions In addition to the design of the skin flaps, the shortening and reconstruction of the eyelid margin and the balance of the levator palpebrae muscle should also be considered for a bigger temporal divided naevus in the eyelid.

关 键 词：眼睑分裂痣 皮瓣 上睑提肌 睑缘 睑板 

分 类 号：R779.6[医药卫生—眼科]