Mohs法控制眼睑恶性肿瘤切除术后Ⅰ期眼轮匝肌蒂翻转皮瓣修复效果观察  

Mohs method to control the effect of I stage orbicularis oculi muscle pedicle turnover flap repair after eyelid malignant tumor resection

作　　者：龚琦[1] 邵庆[1] GONG Qi;SHAO Qing(Department of Ophthalmology,Jiangsu Province Hospital,Nanjing 210029,China)

机构地区：[1]江苏省人民医院眼科,江苏南京210029

出　　处：《哈尔滨医科大学学报》2023年第3期284-288,共5页Journal of Harbin Medical University

基　　金：江苏省自然科学基金资助项目(BK20211380)。

摘　　要：目的研究Mohs法控制眼睑恶性肿瘤切除术后行Ⅰ期眼轮匝肌蒂翻转皮瓣修复的效果。方法回顾性分析本院2019年1月~2021年12月收治的98例(98眼)眼睑恶性肿瘤患者的病历资料,根据手术治疗方案分为研究组50例和对照组48例,研究组予以Mohs法切除术+Ⅰ期眼轮匝肌蒂翻转皮瓣修复治疗,对照组予以Mohs法切除术+异体巩膜移植修复治疗。术后7 d比较两组患者分泌物中结缔组织生长因子(connective tissue growth factor,CTGF)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)、白细胞介素-33(interleukin-33,IL-33)及C反应蛋白(C-reactive protein,CRP)水平。术后1个月比较两组的修复效果、睑裂长度和高度及并发症。术后随访12个月,记录肿瘤复发结局。结果研究组修复效果优于对照组,差异有统计学意义(P<0.05)。术前、术后两组患者的睑裂长度和高度比较差异均无统计学意义(P>0.05)。术后两组CTGF、TGF-β1均升高,研究组高于对照组(P<0.05)。术后两组IL-33、CRP均降低,研究组低于对照组(P<0.05)。研究组患者术后无瘢痕挛缩畸形、眼睑闭合障碍、角膜溃疡、暴露性角膜炎等并发症发生,对照组术后供体组织坏死1例。术后随访12个月,两组患者均未复发。结论Mohs法控制眼睑恶性肿瘤切除术后行Ⅰ期眼轮匝肌蒂翻转皮瓣修复疗效确切且安全性良好。Objective To explore the effect of Mohs method to control the repair of I stage or⁃bicularis oculi muscle pedicled flap after eyelid malignant tumor resection.Methods The medical records of 98 patients(98 eyes)with eyelid malignant tumor admitted to our hospital from January 2019 to December 2021 were retrospectively analyzed.According to the surgical operation,they were divided into the study group of 50 cases and the control group of 48 cases.The study group was treated with Mohs method resection+phase I orbicularis oculi muscle ped⁃icle flap repair,and the control group was treated with Mohs method resection+allograft sclera transplantation repair.Seven days after operation,the levels of connective tissue growth factor(CTGF),transforming growth factor⁃β1(TGF⁃β1),interleukin⁃33(IL⁃33)and C⁃reactive protein(CRP)in the two groups were compared.The repair effect,length and height of eyelid fissure and complications of the two groups were compared one month after operation.And the outcome of tumor recurrence were recorded after followed up for 12 months after operation.Re⁃sults The repair effect of the study group was better than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the length and height of palpebral fissure between the two groups before and after operation(P>0.05).After operation,CTGF and TGF⁃β1 were increased in both groups,the study group was higher than the control group(P<0.05).After operation,the levels of IL⁃33 and CRP were decreased in both groups,and the study group were lower than the control group(P<0.05).There was no scar contracture deformity,eyelid closure disorder,corneal ulcer,ex⁃posed keratitis and other complications in the study group,while there was 1 case of donor tis⁃sue necrosis in the control group.Follow⁃up for 12 months showed no recurrence in both groups.Conclusion Mohs method to control the effect of one⁃stage orbicularis oculi muscle pedicle turnover flap repair after eyel

关 键 词：眼睑 肿瘤 Mohs法 皮瓣修复 

分 类 号：R739.71[医药卫生—肿瘤]