颜面部钙化上皮瘤手术切除范围的研究

Excision range research of pilomatricoma on face

目的：探讨颜面部钙化上皮瘤的有效切除范围及缩小手术切口的疗效和临床意义。方法2012年1月至12月我们收治颜面部单发钙化上皮瘤39例，手术切除范围包括包膜内肿物切除、肿物连同包膜完整切除、包膜外1～2 mm 切除、全层皮肤连同肿物挖除（2～4 mm），手术方式为普通切口，设为普通切口组；2013年1月至12月收治颜面部单发钙化上皮瘤45例，切除范围包括包膜内切除、连同包膜完整切除，手术方式为微小切口，设为微小切口组。比较两组肿物最大直径和切口长度，并从病理特点探讨其有效切除范围的依据。结果两组84例均恢复良好，无一例复发。病理特点：钙化上皮瘤瘤体周边界限清晰，其包膜完全为纤维结缔组织假性包膜，无上皮或内皮结构，包膜周边即正常的皮下组织结构，无增殖的瘤细胞。免疫组化：Ki67（－）。两组肿物直径比较，差异无统计学意义（P ＞0.05）；切口长度比较，差异有统计学意义（P ＜0．05）。术后微小切口组瘢痕小，外形美观，患儿及家属满意度高。结论钙化上皮瘤经临床检查即可诊断，术中无需切除过多的组织，只要将钙化团块完全切除即可，采用微创小切口方法，疗效确切，术后瘢痕不明显，外形美观，患者满意度高。

Objetive To explore the effective excision range and curative effect and clinical importance of small-cut operation in pilomatricoma on face.Methods 39 cases diagnosed as pilomatricoma on face in our hospital from Jan.2012 to Dec.2012 were collected.All these cases were divided into two groups including normal incision group and minus incision group.The maximum diameter of the pilomatricoma and the length of incision were compared and the reasons for resection scope were analyzed.Results All the patients recovered very well and no recurrence was found.There was no statistical difference found in diameter （P ＆gt;0.05）,but there was obvious statistical difference in incision length （P 〈0.05）.Patients in minus incision group were satisfied with the incision because the scar was small. Conclutions Pilomatricoma excision is a good effect due to the minus incision caused.Such an operation only need to cut the calcified clumps rather than cutting too much tissue.