眼部淋巴血管畸形合并囊内出血的外科治疗

Ocular lymphatic vascular malformation combined intracystic hemorrhage of surgical treatment

目的探讨眼部淋巴血管畸形合并囊内出血的手术治疗方法.方法回顾性分析2010年1月至2016年6月河南省立眼科医院和血管瘤外科收治的66例眼部淋巴血管畸形合并囊内出血的病例资料,男31例,女35例,年龄2~25岁.66例均接受手术治疗,从发迹处做弧形切口分离暴露眼部,用针状电极刀头从额部和颞部向眼部沿皮肤真皮下脂肪层分离病变,深处分离显露眼轮匝肌及提上睑肌,针状电刀精细化切除病变并及时止血和将创面病变彻底处理.结果66例患者病变均彻底、完整切除,一期术后外观满意58例;8例切口瘢痕愈合,行择期瘢痕切除并美容修复术后外观满意.术后随访0.5~3.0年,眼部肿块无复发,均达到根治.术后并发症包括切口淋巴液长期渗出6例,其中4例并发切口裂开,2例术区感染.结论及早采用手术完整切除瘤体的方法,可以根治眼部淋巴血管畸形合并囊内出血,防止病情恶化,保护眼睑功能,并能达到外观满意.

Objective To discuss the radical treatment of lymphatic vascular malformation combined intracystic hemorrhage in Children. Methods 66 cases with lymphatic vascular malformation combined intracystic hemorrhage were retrospectively analyzed. The longest diameter of all the lesions was nearly 4 cm.All the 66 patients received surgical treatment. Arc-shaped incision was made to separate and expose the eyes from the hair trace. The lesions were separated from the frontal and temporal parts to the eyes along the dermal fat layer, and deep separation revealed orbicularis oculi muscle and levator upper eyelid muscle. Results All the 66 cases were completely resected, and the patients were followed up for 0.5-3.0 years after the surgery. The postoperative appearance was satisfactory in 58 cases. The wound scar was healed in 8 cases, and the patients had satisfactory postoperative appearance after elective scar resection and cosmetic repair. Postoperative complications included long-term exudation of incision lymph in 6 cases. Among them, 4 cases were complicated with incision dehiscence and 2 cases were infected. Conclusions The method of complete resection of tumor as early as possible can radical cure the ocular lymphangioma with intracapsular hemorrhage, which prevent the disease from deteriorating, and meeting the aesthetic requirements of satisfactory appearance.