CO_2激光治疗睑缘早期基底细胞癌21例临床观察

Superficial Eyelid Margins Basal Cell Carcinoma Treated by CO_2 Laser:Clinical Observation on 21 Cases

目的探求治愈率高、美容效果好、损伤少的睑缘基底细胞癌的治疗方法。方法局麻下对21例已设定切除范围的基底细胞癌在距病灶约1 cm处用功率3-5 W的CO2激光对病灶行气化凝固术使至无肉眼可见病灶,并分别在病灶及其切缘基底部取材行组织病理学检查。结果 21例患者随访1年均无复发。2例患者出现明显瘢痕增生,经处理后瘢痕稳定;1例患者因瘢痕挛缩致眼睑外翻而出现轻度眼睑闭合不全和溢泪现象;其余病例均愈合良好无明显并发症。术后1年痊愈率、显效率和有效率分别为85.7%、9.5%和4.8%。1例随访至4年时发现肿瘤复发入院治疗,无一例死于基底细胞癌复发。结论 CO2激光治疗早期睑缘基底细胞癌术后患者伤口恢复良好,睑板功能基本正常,美容效果佳,复发率低。

Objective To explore a safe and effective laser treatment for eyelid margins basal cell carcinoma.Methods All the 21 cases of tumors were defined the ablation range and marked before the treatment,then the tumors were vaporized following markers with the 3-5 W CO2 laser under local anesthesia condition and the tissues were biopsied at the tumor,the edge of the tumor and the basefond of the tumor.Results No clinical recurrence was observed of the 21 cases for one year followed up,while hypertrophic scarring in two patients and ectropion in one patient were seen.One patient had tumor recurrence after about four years.No patient died of tumor recurrence in this study.Conclusions CO2 laser treatment for superficial eyelid margins basal cell carcinoma is effective and might be recommended for rapid healing,perfect lid function conservation,superior cosmetic result and with low recurrent rate.