睑缘色素痣切除后创面的Ⅰ期修复探讨  

作　　者：包菁[1] 吕志刚[1] 刘秀伦[1] 程雪莹 

机构地区：[1]浙江省金华市中心医院眼科,321000

出　　处：《浙江临床医学》2018年第4期720-722,共3页Zhejiang Clinical Medical Journal

摘　　要：目的总结睑缘色素痣手术切除后创面修复的方法。方法根据睑缘色素痣切除后眼睑缺损创面的层次，大小及形状，选择单纯切除及烧灼、切除后直接缝合或适当的眼睑局部皮瓣修复睑缘缺损，如：“A-T”皮瓣、“矩形”皮瓣、“H”形皮瓣，睑板结膜垂直滑行瓣．共施行手术21例，睑缘病变长度为0．2～0．9cm。单纯切除4例，直接缝合5例，“A-T”皮瓣9例、“H”推进皮瓣1例、“矩形”皮瓣1例，睑板结膜垂直滑行瓣1例。结果本组患者切口均Ⅰ期愈合，12例局部皮瓣全部成活，其中21例术后获得随访1-14周，眼睑外观形态良好，眼睑切口无明显瘢痕，睑缘弧线正常自然，双眼睑形态对称，眼睑闭合功能正常。结论睑缘色素痣根据病变的位置、大小、深度等，灵活选用相应手术方式可获得成功的Ⅰ期创面修复。获得满意的手术效果。Objective To introduce the methods of defects reconstruction after pigmented nevus excision in palpebral margin. Methods According to the Iocation, shape and size of the pigmented nevus in palpebral margin, the following methods were used： simple excision and thermocauterization, excision and direct suture, or application of local eyelid flap to repair the defects ofpalpebral margin, including ＂ A-T＂ skin flap, rectangle skin flap, ＂ H＂ advancement flap and tarsoconjunctival flap.21 patients were treated, with a length of palpebral margin pigmented nevus between 0.2cm and 0.9cm. There were 4 cases with simple excision and thermocauterization, 5 cases with excision and direct suture, 9 cases reconstructed with ＂A-T＂ skin flap, 1 case with ＂ H＂ advancement flap, 1 case with rectangle skin flap, 1 case with tarsoconjunctival flap. Results After 1 to 14 weeks follow-up, 21 cases achieved excellent cosmetic effects and functional results.12 cases with flaps survived with primary healing. Conclusion According to the size, depth, and position of palpebral margin pigmented nevus, we can achieve satisfying primary treatment effects by selecting the corresponding operation methods.

关 键 词：色素痣 睑缘缺损 皮瓣 

分 类 号：R777.2[医药卫生—眼科]