眼睑恶性肿瘤切除后睑板重建方法分析  

Analysis of tarsus plate reconstruction methods after eyelid malignant tumor excision

作　　者：欧阳明[1] 刘桂琴[1] 秦波[1] 周凤[1] 

机构地区：[1]暨南大学附属深圳市眼科医院深圳市眼科医院深圳市眼科学重点实验室,广东518040

出　　处：《中华眼外伤职业眼病杂志》2015年第6期458-460,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的分析眼睑恶性肿瘤切除后的眼睑缺损进行睑板重建的方法。方法回顾性分析2007年1月至2013年12月深圳市眼科医院收治的68例（68眼）眼睑恶性肿瘤的临床资料，其中基底细胞癌46例、睑板腺癌12例、眼睑鳞状细胞癌10例。所有患者均用Mohs法手术切除。根据切除术后睑板缺损的位置和范围，分别采用了不同的重建方法：对于缺损范围等于和大于1／2者，采用硬腭黏膜移植的方法代替睑板；对于缺损范围等于和大于1／4且小于1／2者，采用滑行睑板结膜瓣修复睑板；对于缺损范围小于1／4者，采用直接缝合的方法修复睑板。结果在68例中有42例得到了随访观察，随访观察时问最短为3个月，最长为72个月。其中3例出现睑缘切迹，4例出现倒睫现象，2例基底细胞癌复发再次手术治疗，其余患者眼睑外形及功能基本恢复，睑缘弧度自然，眼睑开闭自如，取得较好的疗效。结论对于眼睑恶性肿瘤切除后的睑板缺损，根据其范围及位置，采取恰当的重建方式，均可取得较好的效果。Objective To analyse the tarsus plate reconstruction methods after eyelid malignant tumor excision. Methods From January 2007 to december 2013, 68 eyes of 68 cases of eyelid malignant tumor treated in Shenzhen Eye Hospital were retrospectively analysed. Among those patients, 46 cases were basal cell carcinoma, 12 cases were meibomian glands cancer and 10 cases were eyelid squamous cell carcinoma. According to the location and scope of tarsus defect after resection, different reconstruction methods were adopted. For the defect range larger than 1/2 of the tarsus, the hard palate mucosa transplantation was performed; For the defect range greater than 1/4 and less than 1/2, the sliding tarsoconjunctival flap forming the opposing lid for repair of tarsus plate was used. For the defect range less than 1/4, direct suture was performed to fix tarsus. Results In the 68 patients, 42 patients got a follow-up observation. The shortest time of observation was 3 months, and the longest time was 72 months. Palpebral margin notch occurred in 3 cases, trichiasis occurred in 4 cases, and the operation was performed again in 2 cases because of recurrence of basal cell carcinoma. The eyelid contour and function were recovered in all the other patients. Conclusion For tarsal defect after eyelid malignant tumor excision, according to the range and position, taking appropriate reconstruction methods can obtain the ideal effect.

关 键 词：眼睑肿瘤 恶性 眼睑缺损 睑板重建术 眼睑成形术 

分 类 号：R739.71[医药卫生—肿瘤]