眼睑肿块的临床病理学特征及手术疗效

Clinical and pathological features and surgical efficacy of eyelid swelling

目的分析眼睑肿块的临床病理特征及其经皮瓣转移切除术治疗的临床效果.方法回顾性病例系列研究.收集嘉兴市第一医院2020年1月至2022年9月眼睑肿块100例的资料,分析其临床特点、病例类型及其接受皮瓣转移切除术治疗的效果.结果本研究中男女比例为1∶1.2,年龄为(46.37±7.58)岁.术中主要采取滑行皮瓣、旋转皮瓣,分别占44%(44/100)、40%(40/100),眼睑肿块主要为良性病变,占比92%(92/100),且良性病变患者年龄明显低于恶性病变患者(P<0.05).分析100例眼睑肿块患者病理学特征显示,良性眼睑肿块病理特征前三位分别为色素痣、皮样囊肿及表皮样囊肿、脂溢性角化病,共占65%(65/100).其中占比最高者为色素痣,占比29%(29/100).恶性眼睑肿块主要为基底细胞癌,占比3%(3/100).治疗后随访6个月,所有患者睑缘位置正常,眼睑形态良好,睑裂可完全闭合,瞬目等功能良好.眼睑活动基本正常,局部瘢痕程度较轻,无明显眼睑闭合不全、外翻等情况.术后无感染、皮瓣坏死、挛缩畸形等并发症发生.患者对眼睑外观形态总体较为满意,其中2例(2%)不满意,50例(50%)基本满意,48例(48%)非常满意,总体满意度为98%.结论眼睑肿块大多为良性病变,行皮瓣转移切除术治疗能够满足患者对眼睑美观及功能的双重要求,安全有效,满意度较高.

Objective To analyse the clinical and pathological features of eyelid swelling and efficacy of transcutaneous flap transfer resection treatment.Methods In this retrospective case series study,the data of 100 patients with eyelid mass in the First Hospital of Jiaxing from Jan.2020 to Sep.2022 were collected.The clinical characteristics,case types and the efficacy of flap transfer resection were analyzed.Results The male-to-female ratio was 1∶1.2 in this study,with an average age of(46.37±7.58)years.The main intraoperative flaps were gliding and rotating flaps,accounting for 44%(44/100)and 40%(40/100)respectively.The patients were mainly benign lesions,accounting for 92%(92/100)of the cases,and patients with benign lesions were significantly younger than those with malignant lesions(P<0.05).Analysis of the pathological features of the 100 patients with eyelid swellings showed that the top three pathological features of benign eyelid masses were pigmented nevi,dermoid cysts,epidermoid cysts,and seborrheic keratosis,accounting for 65%(65/100).Among them,the highest proportion was pigmented nevi,accounting for 29%(29/100).Malignant eyelid masses were mainly basal cell carcinoma,accounting for 3%(3/100)of all cases.At 6 months follow-up after treatment with flap grafting,100 patients had normal lid margin position,good eyelid morphology,complete lid closure and good transient and other functions.Lid movement was essentially normal,local scarring was mild,and there was no significant lid closure incompleteness or ectropion.There were no postoperative complications such as infection,flap necrosis or contracture deformity.Patients were generally satisfied with the appearance and shape of their eyelids,with 2 cases(2%)dissatisfied,50 cases(50%)largely satisfied and 48 cases(48%)very satisfied,giving an overall satisfaction rate of 98%.Conclusion Most eyelid swellings are benign lesions.and treatment with flap transfer resection can meet both the aesthetic and functional requirements of the patient’s eyelid,and is safe,effective and highly satisfactory.