唇黏膜并眶周皮瓣移植修复中重度全层眼睑缺损  

Repair of Moderate to Severe Full-thickness Eyelid Defects with Labial Mucosaorbital Flaps Transplantation

作　　者：刘子瑶[1] 廖丁莹 熊蕾[1] 刘叶子 郑玉萍[1] 熊全臣[1] 王建明[1] LIU Zi-yao;LIAO Ding-ying;XIONG Lei;LIU Ye-zi;ZHENG Yu-ping;XIONG Quan-chen;WANG Jianming(Department of Ophthalmology,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,Shaanxi,China)

机构地区：[1]西安交通大学第二附属医院眼科

出　　处：《中国美容医学》2019年第11期29-32,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:分析唇黏膜并眶周皮瓣移植修复中重度全层眼睑缺损的手术疗效及手术成败的关键影响因素。方法:回顾性病例分析,2010年8月-2017年6月西安交通大学第二附属医院眼科就诊的眼睑肿瘤所致的中重度眼睑全层缺损患者18例(18只眼)。所有患者均行肿瘤彻底切除,一期唇黏膜并眶周皮瓣移植手术治疗,术后观察并随访植片成活情况、睑缘位置、眼睑睁闭功能、外观情况、供皮区愈合情况、患者舒适度、肿瘤是否复发等。结果:18例患者移植唇黏膜及皮瓣均成活、供皮区愈合好、睑缘无明显内外翻、闭合功能良好,1例因上睑皮瓣厚重丧失上睑上提功能,1例长期有不明原因的眼磨不适感。所有眼睑肿瘤患者随访1年以上,均未见肿瘤复发。结论:唇黏膜在眼睑重建中是一种较理想的后层替代材料,唇黏膜并眶周皮瓣移植在中重度全层眼睑缺损的重建中疗效肯定,是可供临床选用的可靠方法,手术的成功与术前、术中的个性化设计及操作技巧密不可分。Objective To investigate the efficacy and key factors of the labial mucosa-orbital flap transplantation applying in the treatment of moderate to severe full-thickness eyelid defect.Methods This was a retrospective case series study(from August 2010 to June 2017).18 eyes of 18 patients with moderate to severe full-thickness eyelid defect induced by eyelid tumor who underwent complete tumors resection and one-stage labial mucosa-orbital flap transplantation were retrospectively reviewed.Survival status of graft,eyelid margin position,eyelid function,appearance,healing of donor skin sites,comfort degree and recurrence of tumor were observed during follow-up.Results A total of 18 patients,all the transplanted lip mucous membranes and flaps were survived,and they all had good healing of donor skin sites and eyelid closure function,without any entropion and ectropion.One eye could not lift upper eyelid that might result from thickness flap.One patient felt uncomfortable without knowing reason.All patients did not have tumor recurrence after surgery following up more than one year.Conclusion Labial mucosa is an ideal substitute in eyelid reconstruction surgery.Labial mucosa-orbital flap transplantation is a reliable clinical method in reconstruction of moderate to severe full-thickness eyelid defect.The key points of successful surgery are closely related to personalized design and operational skill.

关 键 词：眼睑缺损 全层缺损 中重度 唇黏膜 眶周皮瓣 缺损修复 

分 类 号：R622[医药卫生—整形外科]