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目的观察肿瘤切除联合自体结膜移植及局部冷冻术治疗眼表鳞状细胞性肿瘤的疗效。方法对21例眼表鳞状细胞性肿瘤患者采用肿瘤切除联合自体结膜移植及局部冷冻术治疗,分析其疗效。结果病理检查:1良性增生12例,以鳞状细胞增生和乳头状瘤为主。2癌前病变8例,其中非典型增生5例,原位癌3例。3鳞状细胞癌1例。术后情况:19例患者术后角膜上皮愈合良好,1例由于肿瘤范围过大导致上皮层1周后仍未恢复;1例可能角膜与包扎纱布接触,致角膜上皮层不能愈合,佩戴软性角膜接触镜2周后2例患者均恢复正常。1例患者肿瘤复发,行板层角膜移植术,术后随访至今无复发。其他20例患者术后无并发症及复发现象。结论肿瘤切除联合自体结膜移植及局部冷冻术可有效治疗眼表鳞状细胞性肿瘤,降低复发率。
Objective To observe the efficacy of tumor resection combined with autologous conjunctival transplantation and local cryotherapy in the treatment of ocular surface squamous cell carcinoma. Methods Twenty-one patients with ocular surface squamous cell carcinoma were treated with tumor resection combined with autologous conjunctival transplantation and local cryotherapy. The curative effect was analyzed. Results of pathological examination: a benign hyperplasia in 12 cases, mainly squamous cell hyperplasia and papilloma. 2 precancerous lesions in 8 cases, including 5 cases of atypical hyperplasia, carcinoma in situ in 3 cases. 3 squamous cell carcinoma in 1 case. After operation, the corneal epithelium healed well in 19 patients, one case had not recovered after one week because of the over-range of the tumor. One case could contact the cornea with gauze, which caused the corneal epithelium not to heal, After 2 weeks of contact lens, two patients returned to normal. One patient had a tumor recurrence and had a lamellar keratoplasty. No recurrence was observed after the operation. The other 20 patients without postoperative complications and recurrence. Conclusion Tumor resection combined with autologous conjunctival transplantation and local cryotherapy can effectively treat ocular surface squamous cell carcinoma and reduce the recurrence rate.