本文選題：眼瞼缺損 + 眼瞼惡性腫瘤　； 參考：《眼科新進(jìn)展》2017年07期

【摘要】：目的觀察異種脫細(xì)胞真皮基質(zhì)聯(lián)合鄰位皮瓣I期修復(fù)眼瞼惡性腫瘤切除術(shù)后眼瞼全層缺損的臨床療效。方法 35例(35眼)眼瞼惡性腫瘤患者,其中基底細(xì)胞癌21例,瞼板腺癌13例,鱗狀細(xì)胞癌1例;累及上瞼者12例,累及下瞼者23例。所有患者均行術(shù)中冰凍并根據(jù)冰凍結(jié)果確定切緣,腫物切除后眼瞼有不同程度全層缺損。取異種脫細(xì)胞真皮基質(zhì)替代結(jié)膜瞼板組織,根據(jù)皮膚缺損大小做鄰近滑行或轉(zhuǎn)位皮瓣修補(bǔ)眼瞼缺損。術(shù)后觀察皮瓣及口腔修復(fù)膜愈合情況、有無(wú)眼瞼閉合不全及瞼球粘連。結(jié)果隨診半年,異種脫細(xì)胞真皮基質(zhì)已完全溶解,被爬行結(jié)膜上皮覆蓋,皮瓣愈合良好、無(wú)一例皮瓣壞死。其中28例患者術(shù)后恢復(fù)良好,無(wú)眼瞼閉合不全及瞼內(nèi)、外翻。4例患者出現(xiàn)輕度眼瞼閉合不全,均無(wú)暴露性角膜炎。3例患者出現(xiàn)輕度瞼球粘連。結(jié)論異種脫細(xì)胞真皮基質(zhì)可替代瞼板結(jié)膜組織,聯(lián)合鄰位皮瓣治療眼瞼惡性腫瘤切除術(shù)后的眼瞼全層缺損有較好的臨床療效,可減少患者因取口唇黏膜或行二次眼瞼重建的痛苦。
[Abstract]:Objective to observe the clinical effect of xenogeneic acellular dermal matrix combined with adjacent skin flap in the repair of eyelid full-layer defect after eyelid malignant tumor resection. Methods 35 cases (35 eyes) with malignant tumor of eyelid, including 21 cases of basal cell carcinoma, 13 cases of tarsal carcinoma, 1 case of squamous cell carcinoma, 12 cases of upper eyelid involvement and 23 cases of lower eyelid involvement. All the patients underwent intraoperative freezing and the cutting margin was determined according to the frozen results. Acellular dermal matrix was used to replace the conjunctival tarsal tissue, and the skin defect was repaired with adjacent glide or transposition skin flap according to the size of the skin defect. After operation, the healing of flap and oral repair membrane was observed, and there was no eyelid closure and symblepharon. Results after six months of follow-up, the xenogeneic acellular dermal matrix was completely dissolved, covered by the reptile conjunctiva epithelium, the skin flap healed well, and no flap necrosis was found. Among them, 28 cases recovered well after operation, there was no eyelid incompetence and inner eyelid, 4 cases with valgus appeared mild eyelid incompetence, and none of them had mild symblepharon in 3 cases of exposed keratitis. Conclusion xenogeneic acellular dermal matrix can replace the conjunctival tissue of tarsal plate and combined with adjacent skin flap for the treatment of eyelid full layer defect after resection of malignant tumor of eyelid. It can reduce the pain of taking lip mucosa or reconstructing the eyelid.
【作者單位】： 南昌大學(xué)第二附屬醫(yī)院眼科;
【分類號(hào)】：R739.7

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本文編號(hào)：1954726