脱细胞异体真皮在上睑及内眦后层缺损重建中的临床应用  

Clinical application of acellular human dermis graft(Alloderm) for reconstruction of posterior upper eyelid and inner canthus defect

作　　者：马涛[1] 姜利斌[1] 陈妍明 许莲姬[1] 张君毅[1] 韩新鸣[1] 司晔巍[1] MA Tao;JIANG Libin;CHEN Yanming;XU Lianji;ZHANG Junyi;HAN Xinming;SI Yewei(Department of Plastic and Reconstructive Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100005,China)

机构地区：[1]首都医科大学附属北京同仁医院整形美容中心,北京100005

出　　处：《中国美容整形外科杂志》2023年第1期5-7,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 探讨脱细胞异体真皮在上睑及内眦后层缺损重建中的临床效果。方法 回顾性分析自2020年9月至2021年4月,首都医科大学附属北京同仁医院整形美容中心收治眼睑恶性肿瘤切除术后上睑或合并内眦全层缺损7例患者的临床资料。其中上睑4例,内眦合并上睑1例,内眦合并上、下睑2例,采取脱细胞异体真皮修补后层,带蒂皮瓣修补前层。术后随访,评估术后疗效及并发症。结果 7例患者获随访6~12个月,脱细胞异体真皮表面结膜化效果较好,睑板支撑稳定。患者均无结膜充血、异物感等症状;眼球活动度良好,无睑球粘连;无眼睑内翻或外翻。眼睑修复效果评价有效修复率为85.7%(治愈4例,显效1例,改善1例)。结论 在合并有上睑或内眦缺损的眼睑恶性肿瘤切除术后重建中,脱细胞异体真皮是良好的上睑后层替代材料。Objective To investigate the clinical application of acellular human dermis graft(Alloderm) for reconstruction of posterior upper eyelid and inner canthus defects. Methods From September 2020 to April 2021, 7 cases of patients with full-thickness upper eyelid and/or inner canthus defects, by using Alloderm as posterior lamella and pedicled flap as anterior lamella, were analyzed retrospectively. Four cases were upper eyelid defects, 1 case was inner canthus and upper eyelid defects, 2 cases were inner canthus and upper, lower eyelid defects. Follow-up was performed to evaluate complications and surgical results. Results All cases were followed-up for6 to 12 months with good surface conjunctivization and stable tarsal support, without corneal irritation, symblepharon, entropion or ectropion. All patients had no conjunctival hyperemia, foreign body sensation and other symptoms. Eye movement was good. No symblepharon,entropion or eversion of the eyelids occurred. The effective repair rate was 85.7%. Four cases were cured, 1 case was markedly improved,and 1 case was improved. Conclusion Alloderm can avoid corneal injury and symblepharon. This method is a good substitute material for reconstruction of posterior upper eyelid and inner canthus defects.

关 键 词：脱细胞异体真皮 眼睑恶性肿瘤 上睑和内眦缺损 

分 类 号：R779.6[医药卫生—眼科]