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目的探讨眼睑瓣在修复眼睑全层缺损中的应用。方法以睑缘动脉弓为营养血管蒂,在眼睑全层缺损的两侧与缺损底部等高,水平向两侧设计眼睑矩形瓣;若缺损较大,外侧眼睑瓣设计线可绕过眼外眦角(距外眦角0·5cm)延伸到对侧眼睑(上或下眼睑,根据缺损是在下或上眼睑),全层切开后水平向中央缺损区推进,分层缝合修复缺损。结果20例患者应用本法修复,其中眼睑基底细胞癌4例,鳞癌2例,海绵状血管瘤3例,色素痣6例,外伤性缺损3例,先天性眼睑缺损2例。缺损最大水平宽度1·7cm,最小0·7cm。缺损位于上睑6例,下睑14例。所有眼睑瓣均全部成活,修复后的眼睑外形佳,睑缘平滑,睫毛生长正常。结论以睑缘动脉弓为营养血管的眼睑瓣修复眼睑全层缺损是用同类组织修复,手术一次完成,效果良好,且睑缘动脉弓恒定,眼睑瓣血供丰富,是眼睑全层缺损较理想的修复方法。
Objective To investigate the application of the eyelid flap in the repair of eyelid full thickness defects. Methods The eyelid artery arch was used as the nutrient vessel pedicle. The eyelid rectangular flap was designed horizontally on both sides of the eyelid full thickness defect and the bottom of the defect. If the defect was large, the design line of the outer eyelid flap could bypass the extraocular angle (From the outer 0 angle of 0.5cm) to the contralateral eyelid (upper or lower eyelid, depending on the defect is in the next or upper eyelid), after the full-thickness incision level to the central defect area, stratified suture repair defects. Results Twenty patients were repaired by this method. There were 4 cases of basal cell carcinoma of the eyelid, 2 cases of squamous cell carcinoma, 3 cases of cavernous hemangioma, 6 pigmented nevus, 3 cases of traumatic defect and 2 cases of congenital eyelid defect. The maximum horizontal defect width of 1.7cm, the smallest 0.7cm. Defect in the upper eyelid in 6 cases, 14 cases of the lower eyelid. All eyelid valves were all survived, eyelid repair good shape, eyelid smooth, normal eyelashes. Conclusions Eyelid flap with eyelid artery arch is the nutrient vessel for repair of eyelid full thickness defect. It is repaired with the same kind of tissue. The operation is completed once and the effect is good. The eyelid artery arch is constant and the blood supply to the eyelid flap is rich. Repair method.