睑缘色素痣临床特点及手术疗效观察分析

Observation and analysis of the clinical characteristics and operation efficacy of palpebral margin pigmented nevus

目的:探讨睑缘各种色素痣临床特点和手术治疗。方法:回顾性分析26例(26只眼)各种睑缘色素痣患者的临床资料,包括患者的临床特征、治疗方法及疗效观察。7例直径长度<4 mm,未累及睑板与睑结膜的睑缘色素痣,给予单纯切除并表面烧灼;6例直径长度>4 mm,未侵及灰线、未累及睑板和睑结膜的睑缘色素痣,给予皮肤色素痣单纯切除,同时进行皮下分离,将皮肤拉向睑缘进行缝合,修复睑缘皮肤缺损;8例直径长度<7 mm、侵及灰线并累及睑结膜的睑缘色素痣,给予色素痣楔形切除,同时对眼睑睑缘进行水平或者垂直褥式缝合;5例直径长度>7 mm,侵及灰线累及睑结膜的睑缘色素痣,给予皮肤色素痣连同累及的睑板及结膜一并切除,同时进行滑行睑板结膜瓣修复睑缘缺损。结果:26例患者随访6~24个月,所有患者睑缘外观恢复良好,无成角、睑缘内外翻等畸形。结论:睑缘色素痣应根据色素痣的大小、侵及组织的深度和累及的范围,制定相应的手术方案,采用相应的手术方式,可以达到美观及功能满意的治疗效果。

Objective:To investigate the clinical characteristics and surgical operation treatment of various pigmented nevus in palpebral margin.Methods:We retrospective analyzed the clinical datas of 26 cases(26 eyes) of palpebral margin pigmented nevus patients,including clinical features,methods of the treatment and the curative effect.The diameter length of 7 cases were <4 mm;the palpebral margin pigmented nevus which was not involved the tarsal and palpebral conjunctiva;they were given simple excision and surface burning.6 cases of length to diameter >4 mm;nevus was not invaded the gray line,and not involved the tarsal plate and palpebral conjunctiva;they were given skin nevus resection,and subcutaneous separation;we pulled the skin to the palpebral margin to suture,then repaired the eyelid skin defect.8 cases of length to diameter <7 mm;palpebral margin pigmented nevus of invasion the gray line and involvement of palpebral conjunctiva;we gave a pigmented nevus wedge resection,at the same time,vertical or horizontal mattress suture of eyelid palpebral margin.5 cases of length to diameter >7 mm;palpebral margin pigmented nevus of invasion the gray line in palpebral conjunctiva;we gave pigmented nevus of skin together with the tarsus and conjunctival involvement resection,at the same time to repair eyelid sliding tarsoconjuctival flap.Results:26 patients were followed up for 6~24 months.The appearance of palpebral margin recovered well in all patients,no angular,blepharitis,valgus and other deformity.Conclusion:The palpebral margin pigmented nevus should according to the size of nevus,the depth of invasion and the range of involved,to make corresponding operation.We used corresponding operation mode,which can meet the aesthetic and functional satisfactory treatment effect.