累及睑缘的眼睑肿物临床病理特征及手术效果分析  

Clinicopathological features and surgery efficacy for eyelid tumors involving the eyelid margin

作　　者：陈芳 赵明 Chen Fang;Zhao Ming(Department of Ophthalmology,Xinyang Central Hospital,Xinyang 464000,China)

机构地区：[1]信阳市中心医院眼科,信阳464000

出　　处：《中华眼外伤职业眼病杂志》2024年第12期943-948,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的分析累及睑缘的眼睑肿物临床病理特征和眼睑肿物切除联合一期个性化修复的效果。方法回顾性病例系列研究。收集2020年1月至2024年1月信阳市中心医院收治的累及睑缘的眼睑肿物患者共78例的临床资料,所有患者行眼睑肿物切除联合一期个性化修复手术,分析其临床资料、病理资料及手术修复方案,评价手术效果。结果本研究中,男性24例(30.77%),年龄范围5.5~88.0岁,女性54例(69.23%),年龄范围20~74岁;其中下睑肿物55例,上睑肿物21例,上下睑均累及者2例。良性病变65例(83.33%),以皮内痣(31例)最为常见。恶性病变13例(16.67%),以基底细胞癌(9例)最为常见。所有病例均在显微镜下手术切除,根据术中情况采取不同的方式进行修复:创面止血后旷置32例,垂直滑行皮瓣修复26例,水平滑行皮瓣修复3例,松解后直接缝合4例,鼻唇沟旋转皮瓣修复6例,颞侧旋转皮瓣修复9例,硬腭替代睑板修复5例,滑行睑板结膜瓣修复4例。随访6个月,除1例下眼睑邻近泪点病变切除后行垂直滑行皮瓣修复的患者出现局部轻度外翻外,其他皮瓣及移植物均存活良好,眼睑及睑缘形态、功能维持良好。良性及恶性病变在随访期间均未见复发。结论累及睑缘的眼睑肿物中,良性病变为主,以皮内痣较为常见,恶性病变组织学类型以基底细胞癌为常见。显微镜下手术切除是确切的治疗办法,合适的修复方案可获得满意的眼睑功能及美容效果。Objective To analyze the clinicopathological characteristics of eyelid tumors involving the eyelid margin,and evaluate the effect of one-stage personalized repair after microsurgical resection.Methods This was a retrospective case series study.The clinical data of 78 cases of eyelid tumors involving the eyelid margin in Xinyang Central Hospital from Jan.2020 to Jan.2024 were collected.All patients underwent eyelid tumor resection combined with one-stage personalized repair surgery.Clinical data,pathological data,and surgical repair approaches were analysed,and the efficacy of surgery was evaluated.Results Among the 78 cases,24 cases were male(30.77%),aged 5.5-88.0 years,and 54 cases were female(69.23%),aged 20-74 years.There were 55 cases involving the lower eyelid,21 cases involving the upper eyelid,and 2 cases involving both the upper and lower eyelids.There were 65 cases(83.33%)diagnosed with benign eyelid tumors,of which the most common type was intradermal nevi(31 cases).There were 13 cases diagnosed with malignant tumors,of which the most common type was basal cell carcinoma(9 cases).All cases underwent microsurgical resection performed utilizing an operating microscope.The repair approaches for the eyelid defects were designed individually based on the intraoperative situations:wound excluding after wound hemostasis(32 cases),vertical sliding skin flaps repairing(26 cases),horizontal sliding skin flaps repairing(3 cases),suturing the release of cutting edge(4 cases),nasolabial groove rotating skin flaps repairing(6 cases),temporal rotating skin flaps repairing(9 cases),hard palate replacement of meibomian plate repairing(5 cases),and sliding meibomian conjunctival flap repairing(4 cases).During a 6-month follow-up,all skin grafts and flaps were in good condition and the morphology and function of the eyelid and eyelid margin maintained well except for one patient who underwent vertical sliding skin flap repairing after resection of the lesion near the tear spot in lower eyelid experienced mild eyelid evers

关 键 词：眼睑肿物 眼外科手术 修复外科手术 病理 

分 类 号：R73[医药卫生—肿瘤]