睑板结膜瓣在眼睑肿瘤术后眼睑后层缺损修复中的临床应用  

Clinical application of tarso-conjunctival flap in reconstruction of posterior eyeliddefects of eyelid tumors

作　　者：程茜 陈卓杰 何玉仓 张勇 杨巧飞 牟晓欣 牟军 李力群[1] Cheng Xi;Chen Zhuofie;He Yucang;Zhang Yong;Yang Qiaofei;Mou Xiaoxin;Mou Jun;Li Liqun(The First Affiliated Hospital of Wenzhou Medical University, Weazhou 325000, Chin)

机构地区：[1]温州医科大学附属第一医院整形美容科,325000 [2]温州医科大学附属黄岩医院整形美容科,325000

出　　处：《中华整形外科杂志》2018年第6期458-463,共6页Chinese Journal of Plastic Surgery

基　　金：国家自然科学基金（81571923）

摘　　要：目的探讨应用自体睑板结膜瓣一期修复眼睑肿瘤切除术后眼睑后层缺损的效果。方法2014年6月至2016年12月，收治眼睑后层肿瘤患者33例33眼，睑缘色素痣21例，眼睑基底细胞癌7例，睑板腺癌3例，眼睑鳞状细胞癌2例。睑缘痣直接切除，恶性肿瘤按Mohs法（术中送冰冻切片控制切缘）切除。根据缺损范围及部位，灵活应用自体睑板结膜瓣修复眼睑后层缺损，联合眼周皮瓣修复眼睑前层缺损行眼睑再造术。结果术后33例均获3～24个月随访，除缺损区睫毛缺失外，1例出现轻度上睑退缩（退缩量为1mm），后白行恢复。余病例眼睑外形及功能均基本恢复，眼睑活动自如，闭合完全，无其他严重并发症发生。无一例肿瘤复发。结论灵活应用睑板结膜瓣可基本解决大部分眼睑肿瘤切除术后眼睑后层缺损的修复问题，具有较高的临床价值。Objective To explore the application effect of tarso-conjunctival flap for one-stage repairing eyelid posterior defect after resection of eyelid tumors. Methods From June 2014 to December 2016, 33 patients with 33 cases of eyelid posterior tumors were treated, including 21 cases of Pigmented nevus of eyelid, 7 cases of eyelid basal cell carcinoma, 3 cases of eyelid adenocarcinoma and 2 cases of eyelid squamous cell carcinoma. Direct resection was performed for eyelid nevus, Mohs method （intraoperative delivery of frozen sections to control the cut edge） resection was performed for malignant tumors. According to the scope and location of the defect, the tarso-conjunctival flap was used to repair the posterior defect of the eyelid, and the eyelid anterior defect was treated with local flap transfer. Results All 33 patients were followed up for 3 to 24 months. In addition to the absence of eyelashes in the defect area, one case had mild blepharoptomy （ 1 mm） and recovered after self-recovery. The remaining cases had recovered in appearance and function of eyelid with no serious complications. Conclusions The flexible application of tarso-conjunctival flap can basically solve the problem of repairing eyelid posterior defect after resection of eyelid tumors. The operation method has clinical practical value.

关 键 词：睑板结膜瓣 眼睑后层缺损 肿瘤 眼睑 外科皮瓣 

分 类 号：R739.71[医药卫生—肿瘤]