眼睑恶性肿瘤的临床分析

目的分析眼睑恶性肿瘤的临床病理类型和治疗方法。方法对74例眼睑恶性肿瘤患者进行病例回顾性分析。其中,男性35人,女性39人,肿瘤部位:右眼38人,左眼36人,上睑25人,下睑49人,年龄28岁～84岁,平均60.74岁。病理诊断示:基底细胞癌39例,睑板腺癌22例,鳞状上皮细胞癌7例,恶性黑色素瘤4例,小细胞癌1例,小细胞恶性淋巴瘤1例。均采用手术治疗,其中6例因肿瘤侵及眶内,行眶内容剜出术,其余病例皆手术切除肿瘤,于术中送冰冻切片控制切缘(Mohs法)以保证术中完全切除肿瘤组织。眼睑缺损一期手术修复。结果6例行眶内容剜出术患者术后遗留明显的眼眶畸形,须二期行眼眶赝复或眼眶畸形整复术。68例术后眼睑外观满意,视功能无影响。结论眼睑恶性肿瘤多发生于老年人,其中基底细胞癌居第一位,其次为睑板腺癌,鳞状上皮细胞癌占第三位。治疗为手术切除加一期缺损修复,睑板结膜瓣滑行修复眼睑缺损具有操作方便、术后眼睑外形满意的优点。

Clinical Analysis of Eyelid Malignancies

Objective To analyze the histopathological classification and treatment methods of the malignant tumors of eyelids. Methods 74 cases of eyelid malignancies with histopathological diagnosis were retrospectively analyzed. 35 cases were male and 39 cases were female. The age of the patients was ranged from 28 to 84 the mean was 60.74. The incidence of the tumor at right eyelid was 38 eyes, left eyelid was 36 eyes, upper lid was 25 eyes, lower lid was 49 eyes. The histopathological diagnosis was basal cell carcinomas (39 cases), Meibom gland carcinomas (22 cases), squamous cell carcinomas (7 cases), malignant melanoma (4 cases). Orbital exenteration was performed on 6 cases and 68 cases were operated by Mohs surgery and the eyelids were reconstructed at the same time. Results 6 cases with orbital exenteration were left obvious orbital deformity and would be reconstructed. 68 cases had satisfactory eyelid contour without damage of function. Conclusions Eyelid malignancies tend to affect old patients. The three leading malignant tumors were basal cell carcinomas, Meibom gland carcinomas and squamous cell carcinomas. Operation (Mohs surgery and eyelid reconstruction) was the main treatment. The eyelid reconstruction with tarsus-conjunctive flip has better effect.