眼睑肿物切除伴修复临床体会
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摘要
目的探讨眼睑肿物的临床特征、病理分型并总结眼睑缺损修复手术体会。方法回顾性分析2012年4月至2018年12月首都医科大学附属北京友谊医院收治的446例眼睑肿物行肿物切除伴眼睑重建患者的病例资料,分析患者的临床特征、肿物位置、病理结果及手术方法。结果 446例患者中,男性199例,女性247例;平均年龄(51. 96±17. 11)岁。右眼232例,左眼214例;上睑182例,下睑198例,内眦部26例,外眦部21例,眉部19例。101例肿物位于睑缘,其中累及睑缘全层者52例。行病理检查者共404例,恶性12例,良性者392例。良性和恶性肿物切除后均未见复发,最长随访5年。眼睑板层切除伴直接对位缝合231例;行邻近滑行皮瓣或旋转皮瓣修补114例; 101例睑缘肿物,52例累及睑缘全层,其中行眼睑全层切除直接拉拢缝合31例;行颞侧皮瓣旋转修复21例。结论眼睑肿物的病理决定肿物生长特征,需根据各自特点术中注意手术细节。应用最简单的方法,采用邻近组织修复缺损眼睑,最大程度减少对患者外观和眼睑功能的影响是手术成功的关键。
Objective To investigate the clinical features,pathological classification and surgical experience of eyelid tumor. Methods 446 patients in Beijing friendship hospital from April 2012 to December 2018 who underwent resection and eyelid reconstruction were retrospectively evaluated regarding their age,sex,lesion location,pathological results and surgical methods. Results Among 446 patients,199 were men and 247 were women. The average age of the patients was( 51. 96 ± 17. 11) years. As for lesion location,232 cases were found on the right eye,214 cases were found on the left eye,182 cases were found on the upper lid,and 198 cases were found on the lower lid. 26 cases were found on the inner canthus and 21 cases were found on the outer canthus,19 cases were found in brow. The tumor was located in the margin of eyelid in 101 cases,including 52 cases involving the whole layer of the eyelid margin. Among 404 patients that had pathology results,there were 12 cases of malignant tumor and 392 cases of benign tumor. No recurrence was found after resection of all the tumors,and the longest follow-up was 5 years.Eyelid resection with direct suture was conducted in 231 cases; 114 cases were repaired with the sliding and rotation flap. The 52 cases with whole layer of the eyelid margin involvement include 21 cases repaired by temporal flap and 31 cases treated with blepharectomy and direct suture. Conclusion The pathological features determine the growth characteristics of tumors. Attention must be paid to the surgical details according to their characteristics. Using adjacent tissue to repair the eyelid defect and minimizing the impact on appearance and function is the key to successful surgery.
Objective To investigate the clinical features,pathological classification and surgical experience of eyelid tumor. Methods 446 patients in Beijing friendship hospital from April 2012 to December 2018 who underwent resection and eyelid reconstruction were retrospectively evaluated regarding their age,sex,lesion location,pathological results and surgical methods. Results Among 446 patients,199 were men and 247 were women. The average age of the patients was( 51. 96 ± 17. 11) years. As for lesion location,232 cases were found on the right eye,214 cases were found on the left eye,182 cases were found on the upper lid,and 198 cases were found on the lower lid. 26 cases were found on the inner canthus and 21 cases were found on the outer canthus,19 cases were found in brow. The tumor was located in the margin of eyelid in 101 cases,including 52 cases involving the whole layer of the eyelid margin. Among 404 patients that had pathology results,there were 12 cases of malignant tumor and 392 cases of benign tumor. No recurrence was found after resection of all the tumors,and the longest follow-up was 5 years.Eyelid resection with direct suture was conducted in 231 cases; 114 cases were repaired with the sliding and rotation flap. The 52 cases with whole layer of the eyelid margin involvement include 21 cases repaired by temporal flap and 31 cases treated with blepharectomy and direct suture. Conclusion The pathological features determine the growth characteristics of tumors. Attention must be paid to the surgical details according to their characteristics. Using adjacent tissue to repair the eyelid defect and minimizing the impact on appearance and function is the key to successful surgery.
引文
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[6]顼晓琳,李彬,孙宪丽,等. 2639例眼睑肿物临床病理分析[J].中华眼科杂志,2008,44(1):38-41.
[7]范先群,赵莼.眼睑恶性肿瘤诊疗中应关注的几个问题[J].眼科,2008,17(6):361-363.
[8]张晓华,张淑华,王家玲.手术治疗泪小点周围肿物的60例临床分析[J].中国实用医药,2017,12(26):94-95.
[9]朱春霞,朱凯云.睑缘色素痣临床特点及手术疗效观察分析[J].中国社区医师,2014,30(32):55-58.
[10]刘晶,王辉,袁思奇.眼轮匝肌皮瓣及风筝皮瓣修复眼睑黄色瘤术后皮肤缺损对比研究[J].吉林医学,2017,38(9):1767-1768.
[2]李铮,李英俊,吴成哲. 105例眼睑肿物临床病理分析[J].延边大学医学学报,2016,39(2):132-134.
[3]洪瑾,张志强,刘宇,等. 212例眼睑肿物临床病理分析[J].临床眼科杂志,2016,24(6):555-557.
[4]邢枫.眼睑肿物282例组织病理分析[J].中华实用诊断与治疗杂志,2011,25(8):804-805.
[5]李春建,张莹,章志扬. 80例眼睑肿物临床及病理学分析[J].中华肿瘤防治杂志,2018,25(2):14-15.
[6]顼晓琳,李彬,孙宪丽,等. 2639例眼睑肿物临床病理分析[J].中华眼科杂志,2008,44(1):38-41.
[7]范先群,赵莼.眼睑恶性肿瘤诊疗中应关注的几个问题[J].眼科,2008,17(6):361-363.
[8]张晓华,张淑华,王家玲.手术治疗泪小点周围肿物的60例临床分析[J].中国实用医药,2017,12(26):94-95.
[9]朱春霞,朱凯云.睑缘色素痣临床特点及手术疗效观察分析[J].中国社区医师,2014,30(32):55-58.
[10]刘晶,王辉,袁思奇.眼轮匝肌皮瓣及风筝皮瓣修复眼睑黄色瘤术后皮肤缺损对比研究[J].吉林医学,2017,38(9):1767-1768.