眼睑广泛恶性肿瘤切除及成形术  

EXCISION OF EXTENSIVE EYELID MALIGNANT TUMOR AND PRIMARY PLASTIC SURGERY REPAIP

作　　者：何庆华[1] 宋琛[1] 

机构地区：[1]解放军总医院

出　　处：《解放军医学杂志》2002年第2期145-146,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：根据不同类型的肿瘤 ,选用最佳距离切除。在冰冻组织学监控下证实切缘无癌细胞者 ,采用多个邻近皮瓣 ,用滑行或旋转的方法 ,同时将残余全层眼睑与骨膜分开 ,使之完全游离 ,以便修复大面积缺损 (缺损最小 2 5mm× 2 0mm ,最大 75mm× 6 5mm)。结果表明 ,所有病人均取得了较好的外观。 36例中 35例保存了视功能。追踪 5年以上无复发 ,1例鳞癌患者肿瘤侵及鼻腔、副鼻窦 ,术后并发脑膜炎 ,对症用药后痊愈 ,无后遗症。结果提示 :用多个邻近皮瓣修复眼睑广泛恶性肿瘤切除后的大范围缺损 ,操作简便 ,即时直接转移皮瓣覆盖缺损 ,手术一次完成 ,缩短了疗程 ,减少了病人再手术的痛苦 ,因此是眼睑复杂成形术的理想方法之一。The optimal distance from tumor to incision varied according to the cellular type of the tumor. In each case the cutting edge of the excised tissue was checked with frozen sections for cancer cells. Multiple neighboring skin flaps in full thickness raised from the periosteum were used to cover the large defects (the smallest defect is 25 20mm, the largest one is 75 65mm). The results showed that good cosmetic results were obtained in all cases, visual function was preserved in 35 of the 36 patients, and no recurrence of the tumor was found in 5 years' follow-up. One patient with squamous cell carcinoma that disseminated to nasal cavity and sinuses had a complication of meningitis after the operation,and it was cured with proper treatment.

关 键 词：眼睑恶性肿瘤 成形术 切除术 

分 类 号：R739.71[医药卫生—肿瘤] R730.56[医药卫生—临床医学]