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目的探讨结膜恶性黑色素瘤的手术治疗方法。方法 1997年1月-2007年1月收治结膜恶性黑色素瘤48例,均为单眼。肿瘤范围:<1/3眼睑长度及结膜14例,>1/3眼睑长度,部分穹隆结膜受累19例,上下眼睑及内外眦大部分结膜受累者15例。采用单纯肿瘤切除术、单纯肿瘤切除联合液氮冷冻治疗、眼眶内容物剜除术3种治疗方法。结果所有患者均经病理学证实为结膜恶性黑色素瘤。术后48例进行9个月～5年随访,15例眶内容物剜除术,3例死于肺及颅脑转移;14例单纯扩大肿瘤切除联合液氮冷冻治疗,2例死于肝转移;19例单纯扩大肿瘤切除术,6例分别死于肝、肺及颅脑转移。结论早期诊断并选择积极有效的手术治疗是提高患者生存率,改善生存质量的重要手段。手术切除联合液氮冷冻法可有效降低肿瘤复发,避免影响患者视觉质量和外观,是治疗结膜恶性黑色素瘤的一种有效方法。
Objective To investigate the surgical treatment of conjunctival malignant melanoma. Methods From January 1997 to January 2007, 48 cases of conjunctival malignant melanoma were accepted, all of which were monocular. Tumor range: <1/3 eyelid length and conjunctiva in 14 cases,> 1/3 eyelid length, partial vault conjunctiva involvement in 19 cases, upper and lower eyelids and most of the conjunctiva were affected in 15 cases. Simple tumor excision, simple tumor resection combined with liquid nitrogen cryotherapy, removal of orbital contents three kinds of treatment. Results All patients were pathologically confirmed as conjunctival malignant melanoma. Forty-eight patients were followed up for 9 months to 5 years. Fifteen patients underwent orbital debridement and 3 died of lung and brain metastases. Of the 14 patients who underwent simple expansive tumor resection combined with liquid nitrogen cryotherapy, 2 died of liver metastasis 19 cases of simple expansion of tumor resection, 6 cases died of liver, lung and brain metastasis respectively. Conclusion Early diagnosis and selection of positive and effective surgical treatment is an important means to improve the survival rate of patients and improve the quality of life. Surgical resection combined with liquid nitrogen freezing can effectively reduce tumor recurrence and avoid affecting the visual quality and appearance of patients, which is an effective method for the treatment of conjunctival malignant melanoma.