眼睑恶性肿瘤切除联合半层耳廓移植眼睑重建术的疗效观察  

Autologous auricular cartilage grafting-based eyelid reconstruction following malignant tumor resection: an observational study

作　　者：倪朝海 朱萍[2] 

机构地区：[1]江苏省盐城市响水县人民医院眼科,224600 [2]江苏盐城市建湖县建阳眼科医院眼科

出　　处：《中华眼科医学杂志（电子版）》2014年第5期16-20,共5页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

摘　　要：目的探讨半层耳廓移植眼睑重建术修复眼睑恶性肿瘤切除术后眼睑缺损的临床效果。方法收集江苏省盐城市响水县人民医院眼科和江苏省盐城市建湖县建阳眼科医院眼科收治的眼睑恶性肿瘤切除术后46例（46只眼）眼睑缺损患者的临床资料。按照患者的睑板缺损程度将患者分为两组,将眼睑缺损长度〉5 mm的患者作为大恶性肿瘤组25例（25只眼）,将眼睑缺损长度〈3mm的患者作为小恶性肿瘤组21例（21只眼）,对所有患者进行半层耳廓移植眼睑重建术。采用χ2检验的方法比较大肿瘤组和小肿瘤组,上睑组和下睑组,睑板组和皮肤组患者术后的临床疗效。结果大肿瘤组患者耳廓皮肤存活,新睑缘皮肤与羊膜愈合良好,眼睑活动自如。随访12~36个月,大肿瘤组疗效满意的患者共17例（17只眼）,占68%;有效的患者8例（8只眼）,占32%,未发生植片脱落及缝线崩脱。小肿瘤组疗效满意的患者共19（19只眼）,占90.5%;有效的患者2例（2只眼）,占9.5%,两组患者的临床疗效比较,差异无统计学意义（χ2=2.20,P〉0.05）。上睑组疗效满意的患者共11例（11只眼）,占77.3%;有效的患者共4例（4只眼）,占22.7%。下睑组疗效满意的患者共6例（6只眼）,占66.7%;有效的患者共3例（3只眼）,占33.3%,上睑组与下睑组患者的临床疗效比较,差异无统计学意义（χ2=0.47,P〉0.05）。睑板组疗效满意的患者共7例（7只眼）,占77.7%;有效的患者共2例（2只眼）,占22.2%。皮肤组疗效满意的患者共4例（4只眼）,占66.7%;有效的患者共2例（2只眼）,占33.3%,两组患者的临床疗效比较,差异无统计学意义（χ2=0.21,P〉0.05）。结论采用半层耳廓移植眼睑重建术修复眼睑恶性肿瘤术后眼睑缺损的临床疗效较好,适用于不同程度的眼睑缺损患者。Objective To prospectively evaluate the outcome of autologous auricular cartilage grafting-based eyelid reconstruction following resection of malignant eyelid tumors. Methods A total of 46 patients （46 eyes ） with eyelid damage after undergoing malignant eyelid tumor resection in the Department of Ophthalmology in both Xiangshui People＇s Hospital, Xiangshui County, Jiangsu and Jianhu Hospital,Jianhu Country, Jiangsu recruited. They were classified into a large malignancy group where the diameter of the tumor-invaded eyelid area was 3-5 mm and the length of the resection procedure-associated eyelid damage was 〉 5 mm and a small malignancy group the diameter of the tumor-invaded eyelid area was ≤ mm and the length of the resection procedure-associated eyelid damage was 〈 3 mm. Autologous auricular cartilage grafting was performed in all patients. Post-operative follow-up was carried out for 12-36 months. Clinical outcome were comparatively evaluated in the two groups of patients. Results In the 46 patients ,25 had large malignant eyelid tumors and 21 had small ones. All patients survived during the 12- 36 month follow-up period. In the large tumor group, 17 （68%）patients achieved a satisfactory eyelid function recovery and 8 （32%） achieved substantial eyelid shape and function improvements. In the small tumor group, 19 （90.5%） patients achieved a satisfactory eyelid function recovery and 2 （9.5%） achieved substantial eyelid shape and function improvements. Differences in these two measures between large and small malignant tumor groups were not statistically significant （k） = 2. 20, P 〉 0. 05 ）, Upper eyelid reconstruction was satisfactory in 11 （77.3%） and effective in 4 （22.7%） out of 15 cases. Lower eyelid reconstruction was satisfactory in 6 （66.7%） and effective in 3 （33.3%） out of 9 cases. The differences in the satisfaction and effectiveness rates were not significant difference between upper and lower eyelid groups（X2 = 0.47, P 〉0.05 ）. The tissue or

关 键 词：眼睑恶性肿瘤 眼睑缺损 半层耳廓 缝合错位 

分 类 号：R739.71[医药卫生—肿瘤]