硬腭粘膜移植联合上睑皮瓣转移行下睑成形术的临床应用  

Clinical application of hard palate mucosa transplantation combined with upper eyelid transferring skin flap in lower eyelid reconstruction

作　　者：王萍 余建洪 张弛 彭英姿 WANG Ping;YU Janhong;ZHANG Chi;PENG Yingzi(Foshan Huaxia Eye Hospital,Foshan 528000,China)

机构地区：[1]华厦眼科集团医院佛山华厦眼科医院,广东佛山528000

出　　处：《现代医院》2020年第5期735-737,共3页Modern Hospitals

基　　金：华厦转化医学青年基金立项项目(2017-D-001)。

摘　　要：目的探讨利用上睑转移皮瓣联合硬腭粘膜移植修复重度下眼睑全层缺损的临床疗效。方法临床选用10例因下睑恶性肿瘤切除术所致重度(超过3/4)全层下睑缺损患者,用患者自体游离硬腭粘膜植片替代睑板和结膜以重建缺损的眼睑后层;用同侧眼上睑转移带蒂皮瓣修复缺损的眼睑皮肤肌层以重建缺损的眼睑前层。结果术后患者随访18个月,自体游离硬腭粘膜植片与上睑转移皮瓣全部成活,下眼睑外观与健眼接近,无明显畸形,睑缘弧度良好;眼睑上提与闭眼功能基本正常;无眼睑内翻、外翻及倒睫等合并症;改善眼睑外观及功能满意。结论自体硬腭粘膜联合上睑转移皮瓣行眼睑原位成形术重建全层下睑重度缺损,可以一期修复缺损的下眼睑前后部分,疗效肯定,对临床应用具有较好的指导意义。Objective To study the clinical effect of combining upper eyelid skin flap and hard palate mucosa in the reconstruction of severe full-thickness lower eyelid defects. Methods In 10 patients with severe lower eyelid defect caused by resection of malignant tumor of eyelid( more than 3/4),autologous free hard palate mucosa instead of tarsal plate and conjunctiva was used to reconstruct the posterior eyelid layer. The defective eyelid skin muscle layer was repaired with ipsilateral upper eyelid transfer pedicled skin flap to reconstruct the anterior eyelid layer. Results In 18 months of follow-up,all of the hard palate mucosa grafting plates and transfer flaps survived,and eyelid appearance was similar to the healthy eye,with no obvious deformity. The curvature of the eyelid margin was good. The function of lifting and closing of the eyelid was basically normal. There were no complications such as eyelid varus,valgus and trichiasis,and the appearance and function of the eyelid were both improved. Conclusions Autologous hard palate mucosa combined with upper eyelid transfer flap for reconstruction of severe lower eyelid defect can be used to repair the anterior and posterior part of the lower eyelid with primary reconstruction. The curative effect is definite and has a good guiding significance for clinical application.

关 键 词：眼睑成形术 下睑全层缺损 硬腭粘膜 上睑转移皮瓣 下睑重建 

分 类 号：R739.7+1[医药卫生—肿瘤]