面部原发基底细胞癌的临床特征及手术治疗

The clinical features and surgical treatment of facial basal cell carcinoma

目的:探讨面部五官原发基底细胞癌(BCC)的临床特征及合理的手术治疗方案。方法:总结分析37例面部五官部位原发BCC的临床特征。手术切除原发病灶,术中冷冻病检,保证切缘干净;选择适合的皮瓣修复缺损。结果:术后随访12~36个月。37例中2例侧切缘见癌细胞残留,于术后4~6个月局部复发,局部复发率5.41%(2/37),治愈率94.59%(35/37)。切除后缺损区选用合适皮瓣修复,4例出现边缘部分坏死,经换药处理后愈合;其余全部皮瓣成活,外观效果满意。结论:面部五官原发BCC临床特征多种多样。首次彻底切除原发灶、保证切缘干净是治疗成功的关键;选择适合的方法修复缺损,可取得满意疗效。

Objective：To investigate the clinical features and reasonable surgical treatment of facial basal cell carcinoma（BCC）.Method：The clinical features of primary facial BCC from 37 patients were analyzed.All patients were cured by standard surgical excision with intraoperative frozen section examination and ensuring margins negative,the defects were reconstructed by using adaptive flaps after resection.Result：The patients were followed up for 12 to 36 months after operation.Two cases of 37（2/37,5.41%）with unclear margin developed local recurrence during 4-6 months after resection,the cure rate was 94.59%（35/37）.Except 4 cases were suffered with distal skin flap necrosis,the others were well developed.Conclusion：The clinical feature of primary facial basal cell carcinoma was various.The complete resection of primary nidus with clear margin is the key to a successful treatment of facial basal cell carcinoma,and satisfactory therapeutic effects can be obtained after repairing defects by using adaptive flaps after resection.