眼睑近泪小点肿物切除56例疗效分析

Surgical treatment of 56 cases of eyelid tumors close to lacrimal punctum

目的探讨并观察近泪小点的眼睑肿物切除的效果。方法门诊就诊的56例（56眼）眼睑近下泪小点肿物患者,局部麻醉后先行泪道环形硅胶管置管保护泪小点及泪小管,于手术显微镜下行肿物切除术,肿物行病理学检查,置管2~4周后将其拔除,术后观察眼睑肿物有无复发及泪小点位置和泪道是否通畅。结果术后病理报告显示：鳞状乳头状细胞瘤6例,色素痣26例,疣10例,炎性肉芽肿14例。追踪观察1 a以上,无一例复发。50例术后泪小点位置正常,冲洗泪道通畅,无溢泪现象;2例肿物较大,术后泪小点口向鼻侧稍有扩大,患者遇刺激时稍有溢泪现象。结论对眼睑近泪小点肿物,先行微创泪道环形硅胶管置管后再切除眼睑肿物,该方法可提高治愈率,值得在临床中推广应用。

Objective To analyze the therapeutic effects of the surgical treat- ment of eyelid tumors close to lacrimal punctum. Methods Fifty-six eyes of 55 cases with eyelid tumors close to lacrimal punctum were enrolled, the operation under micro- scope before taking local anaesthesia and intubation procedure for protection of lacrimal punctum and canaliculi was performed, the tumor tissue was pathological examined, and the tube was removed after 2 weeks. The reoccurrence of tumor and lacrimal ducts were observed. Results The postoperative pathological reports showed that 6 cases was squamous papillary cell tumor,26 cases was pi/~3nented nevus, l0 cases was warts, 14 ca- ses was inflammatory granuloma. To follow-up observation of one year or more,no reoc- currence was seen. The location of lacrimal punctum were normal in 50 cases, the lacri- mal ducts were unobstructed with no epiphora. The nasal opening of lacrimal punctum in 2 cases with large tumor was enlarged, and the epiphora appeared when facing the stimu- lation. Conclusion For the eyelid tumors close to lacrimal punctum, taldng excision operation under microscope after intubating procedure to protect the lacrimal punctum and canalicnli can improve the curative rate, worthy for widely application in clinic.