眼睑木村病临床特点与手术方法探讨

Clinical Characteristics and Surgical Methods of Eyelid Kimura’s Disease

目的:分析眼睑木村病(Kimura’s disease)的病因、病理、临床特征及手术治疗方法,为今后治疗该类疾病奠定基础。方法:回顾性分析2000年1月-2018年12月于笔者医院眼科治疗的8例(10眼)眼睑木村病患者的临床资料,均在局麻下沿设计线切开皮肤并分离皮下组织暴露肿物,彻底切除肿物,并行提上睑肌缩短术,按重睑线设计缝合,以改变患者容貌,术后1周口服强的松,随访观察2~5年。分析病因、病理改变,观察临床特点,术前进行血液学、影像学及病理学检查,制定本病诊断标准,并评估术后效果。结果:所有患者眼睑肿物未见复发,上睑下垂矫正满意,上睑高度、睑裂大小、眉间距、重睑线自然顺畅。结论:所有患者均经病理证实为木村病,临床表现为良性无痛性缓慢生长病程。对局限性肿块切除辅助糖皮质激素治疗,基本能够治愈,病变累及提上睑肌致上睑下垂者,行提上睑肌缩短术矫正,手术安全,效果确切。

Objective To analyze the etiology,pathology,clinical characteristics and surgical treatment of Kimura's disease,and lay a foundation for the treatment of this disease in the future.Methods The clinical data of 8 cases(10 eyes)of Kimura’s disease treated in our department of ophthalmology from January 2000 to December 2018 were retrospectively analyzed.Under local anesthesia,the skin was incised along the design line and the subcutaneous tissue was separated to expose the tumors.The tumors were thoroughly removed.The levator palpebrae muscle was shortened and sutured according to the double eyelid line to change the patient's appearance.Prednisone was orally administered one week after operation.Follow-up observation was conducted for 2-5 years.The etiology,pathological changes,clinical features,preoperative hematological,imaging and pathological examinations were analyzed,the diagnostic criteria of the disease were formulated,and the effect of the operation was evaluated.Results All patients had no recurrence of orbital masses,and the surgical effect was satisfactory.The upper eyelid height,palpebral fissure size,eyebrow spacing,and double eyelid line were naturally smooth.Conclusion The treated patients were confirmed by pathology as Kimura’s disease,and the clinical manifestations were painless and growth slowly.The treatment of localized mass can be completely cured when it cooperate with glucocorticoid therapy.It is exactly safe to use Levator palpebrae shortening to treat these patients who’s palpabralis were invaded.