眼睑分裂痣手术切除及美容修复的临床分析

发布时间：2018-03-03 13:14

本文选题：眼睑分裂痣　切入点：眼睑缺损　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究目的:总结22例眼睑分裂痣患者,手术切除后个性化美容修复继发性眼睑缺损的方法与体会。方法:收集2010年1月至2016年12月在我科行眼睑分裂痣手术治疗的22例患者,男性8例,女性14例,年龄在5-38岁之间,平均年龄为19.2岁,左眼10例,右眼12例。病变部位:近眼睑内眦部10例,近眼睑中部4例,近眼睑外眦部8例。侵及睑缘、结膜者8例,仅累及浅层者14例。病变面积:上睑0.4cm×0.3cm~2.3cm×1.5cm,下睑0.3cm×0.2cm~2.5cm×2.4cm。根据分裂痣的部位、形态、面积、深度、年龄、皮肤松弛度及缺损修复后供区的代价等多方面综合考量设计不同的皮瓣修复继发缺损,达到美容效果。术后随访1、3、6、12个月,对眼睑对称性、瘢痕、眼睑活动性、眼睑退缩、眼睑外翻、上睑臃肿、内、外眦角畸形、分裂痣复发、患者舒适度等术后效果进行评价(未设对照组)。结果:所有患者术后皮瓣成活良好,切口愈合良好。术后1、3、6、12个月随访观察,22例患者的双眼对称性好,瘢痕均不明显,眼睑睁闭自然,无眼睑外翻现象,无上睑臃肿,分裂痣均无复发,无不适感。20例患者眼睑形态良好,1例有轻度下眼睑退缩,行眼袋切口的下睑退缩矫正术(外眦韧带悬吊术),术后临床效果满意。1例出现外眦角轻度变形,睑裂略短,但不影响眼睑整体形态。结论:1.眼睑分裂痣切除后眼睑缺损的修复,首选推进皮瓣,可以在推进皮瓣的基础上,灵活结合其他局部皮瓣进行修复。2.下眼睑分裂痣且面积较大时,可应用眼轮匝肌为蒂的岛状皮瓣修复。3.累及睑缘及睑结膜者,可酌情保留睑缘及睑结膜,定期复查。4.各种皮瓣的设计,尽量做到辅助切口少,皮瓣转移后切口尽量隐蔽,与睑缘、眉毛或与皮纹线、皱纹线、轮廓线平行,以隐蔽瘢痕。5.眼睑分裂痣的修复应根据部位、形态、面积、深度、年龄、皮肤松弛度以及缺损修复后供区的代价采取个性化设计。
[Abstract]:Objective: to summarize the method and experience of 22 cases of eyelid split nevus treated by individualized cosmetic repair after operation. Methods: from January 2010 to December 2016, 22 patients with eyelid split nevus were treated by operation in our department. Male 8 cases, female 14 cases, age 5 to 38 years old, mean age 19.2 years, left eye 10 cases, right eye 12 cases. Lesion location: proximal eyelid medial canthus 10 cases, proximal eyelid middle 4 cases, proximal eyelid outer canthus 8 cases. There were 8 cases of conjunctiva and 14 cases of superficial layer involvement. The lesion area was 0.4cm 脳 0.3cm of upper eyelid, 2.3cm 脳 1.5cm of lower eyelid, 2.5cm 脳 2.4cm of lower eyelid, according to the location, shape, area, depth, age of mitotic nevus. Different skin flaps were designed to repair the secondary defects in order to achieve cosmetic effect. The postoperative follow-up was 1: 3 for 6 months and 12 months for eyelid symmetry, scar, eyelid activity, eyelid retraction, and so on, including the skin relaxation and the cost of the donor area after repairing the defect. The postoperative effects of ectropion, bloated upper eyelid, inner and outer canthus angle malformation, recurrence of fission nevus and comfort degree of the patients were evaluated. Results: the flap survived well in all the patients. The incision healed well. All the 22 cases were followed up for 12 months. The symmetry of the eyes was good, the scar was not obvious, the eyelid was open and closed naturally, there was no eyelid ectropion, the supreme eyelid was bloated, and there was no recurrence of mitotic nevus. No discomfort. 1 case with mild lower eyelid retraction was treated with lower eyelid retraction through pouch incision (external canthus ligament suspension). The clinical results were satisfactory in 1 cases with slight deformation of the outer canthus angle and slightly short eyelid fissure. But it does not affect the overall shape of eyelid. Conclusion 1. The first choice of propelling flap is to repair eyelid defect after eyelid mitotic nevus resection, which can be combined with other local skin flap flexibly to repair lower eyelid mitotic nevus when its area is larger. The island flap pedicled with orbicularis oculi muscle can be used to repair .3.If the eyelid rim and the eyelid conjunctiva are involved, the eyelid edge and eyelid conjunctiva can be preserved, and the design of various kinds of flaps should be reviewed periodically, so as to minimize the auxiliary incision and conceal the incision after the flap transfer. Parallel to the margin of the eyelid, eyebrows or lines of skin, lines of wrinkles, contours, to conceal scar .5.The repair of mitotic nevus of the eyelid should be based on location, shape, area, depth, age, etc. The skin relaxation and the cost of the donor area after repairing the defect were individualized.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R779.6;R62

【相似文献】