眼睑分裂痣的手术方法选择

Surgical treatment of eyelid divided nevus

目的 探讨眼睑分裂痣的不同手术方法及效果.方法 2000年1月至2014年1月收治27例27只眼睑分裂痣,2例采用分次切除,20例采用全厚皮片移植,3例采用额部及面部扩张皮瓣修复,另2例因面积较大采用扩张皮瓣联合皮片移植.结果 除1例患者因色素痣面积较大遗留0.5 cm×0.5 cm的病变外,其他病例痣全部切除,所有病例伤口均一期愈合.术后随访3～48个月,平均7.4个月,1例患者在皮片移植术后由于对瘢痕不满意而进行了面部扩张器治疗,其他病例对手术效果满意,且未复发,眼睑外形自然,功能正常.结论 分次切除及全厚皮片移植是治疗眼睑分裂痣简单有效的方法,面积较大时采取扩张皮瓣或联合全厚皮片移植可以获得较好的治疗效果.

Objective To investigate the surgical techniques and therapeutic effect of eyelid divided nevus.Methods From January 2000 to January 2014,27 cases with 27 eyelid divided nevi were treated by staged excision （2 cases）,or full-thickness skin graft （20 cases） or frontal and facial expanded flaps （3 cases）,or combined expanded flaps with skin grafts （2 cases） for large lesions.One case with skin graft underwent secondary treatment with expanded flap due to obvious scar.Results Except for one case with residue lesion （0.5 cm× 0.5 cm）,all the other cases underwent successful treatment with primary healing.All the patients were followed up for 3-48 months （average,7.4 months）.Except for one case with secondary expanded flap treatment,all the other patients were satisfied with aesthetic and functional results.No occurrence happened.Conclusions Staged excision and full-thickness skin grafts are simple and effective method for eyelid divided nevus.For large lesions,expanded flap,or combined with skin graft should be considered.