眼睑肿物252例病理分析

Clinical and pathological analysis of 252 cases of eyelid tumors

目的探讨眼睑肿物的临床、病理学分类以及手术方法。方法回顾2009—2012年在天津市第三中心医院眼科收治252例眼睑肿物患者年龄分布及病理分类；结合肿物特性讨论肿物切除手术注意问题。结果恶性肿瘤前3位为基底细胞癌、睑板腺癌、鳞状细胞癌；良性肿瘤前5位为表皮样囊肿、色素痣、乳头状瘤、慢性肉芽肿、皮脂腺囊肿。研究中所有患者均经手术切除，病理诊断明确。其中良性肿瘤采取单纯肿物切除，恶性者行肿物及外周正常组织5mm切除，二者均采用滑行、旋转皮瓣及游离植皮修复创面，对缺损大者行眼睑再造术。术后半年至5年随访观察，术后愈合好，眼睑外形明显改观，未见复发。结论对眼睑肿物的病理分类有助于疾病的临床诊断，并对治疗方案的选择提供指导。

Objective To analyze the clinical characteristics, histopathological classification and surgical procedure of eyelid tumors. Methods The age differentiation and clinical feature of 252 pa- tients with eyelid tumors between 2009 and 2012 were retrospectively analyzed. The attentive pro- grams in the operation were discussed according to the characteristic of the cases. Results The three leading malignant eyelid tumors were basal cell carcinoma, meibomian gland carcinoma and squamous cell carcinoma. The top five of benign tumors were epidermoid cyst, benign nevi, papillo- ma, chronic granuloma, sebaceous cyst. All the patients were received the surgery, the pathological diagnosis was clear. The benign tumor was excised simply, malignant tumor and peripheral normal tissue 5mm was excised, adopted the sliding, rotation flap and free skin graft to repair the wound, the defect underwent reconstruction of eyelid achieved. All the patients were follow-up for 6-60 months, the wound was healed, the eyelid shape was repaired, and the lesion was no recurrent. Conclusions The outcome of analysis to eyelid tumor is favorable to instruct clinical diagnosis and treamaent.