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1、硬腭黏膜移植联合皮瓣转移修复眼睑全层缺损的临床应用浙江省丽水市人民医院眼科,浙江丽水323000[摘要]目的探讨硬腭黏膜移植联合周围皮瓣转移修复眼脸全层缺损的临床疗效。方法対2011年3月〜2013年3月,于丽水市人民医院眼科诊治的12例眼睑恶性肿瘤(基底细胞癌6例,睑板腺癌2例,鳞状上皮细胞癌2例,恶性黑色素瘤2例)行冰冻切片监控肿瘤边缘切除后全层眼睑缺损的患者,术屮川口体游离硬腭黏膜移植片替代睑板和结膜,再造后层眼睑;转移周围皮瓣覆盖于硬腭黏膜之上,代替缺损的眼睑皮脐进行眼睑重建。术后对眼睑形态、眼睑功能进行观察。结果术后随访6〜24个月,所冇患者硬腭黏膜植片及
2、转移皮瓣全部成活,眼睑形态及功能均基木恢复,眼脸活动自如,闭合良好,无挛缩,无眼脸内外翻畸形,无一例复发。结论采用硬腭黏膜移植联合周围皮瓣转移,可以一次性修复恶性肿瘤切除术后全层缺损的皮肤、睑板、结膜,效果肯定,值得推广。[关键词]硬腭黏膜;移植;眼睑重建[中图分类号]R782[文献标识码]A[文章编号]1673-7210(2014)03(c)-0071-04Clinicalapplicationofhardpalatemucosalgraftcombiningwithskinflaptransferinreconslruclionoffull-thicknesse
3、yeliddefectsLIUQinglinWUBoleLUXianghongIIUXiayunYEXinmingGAOIlexiangDepartmentofOphthalmology,People,sHospitalofLishuiCity,ZhejiangProvince,Lishui323000,China[Abstract]ObjectiveToinvestigatetheoutcomeofcombininggraftingofhardpalatemucosaandperiocularskinflapinthereconsWuctionoffull-thi
4、cknesseyeliddefects.MethodsFromMarch2011toMarch2013,inPeople,sHospitalofLishuiCity,12casesofeyelidmalignanttumor(6casesofbasalcollcarcinoma,2casesofmeibomianglandcareinoma,2casesofsquamouscel1careinoma,2casesofmalignantmelanoma)wereresectedtheposteriorlayersoftheeyelidunderthemonitorin
5、gofthetumoredgebyfrozensection,autologousfreehardpalatemucosawasgraftedtoreplacethetarsalandtheconjunctivatoreconstructtheposteriorlayersoftheeyelid;periocularskinflapwastransferredtocoverthehardpalatemucosainsteadoftheeyelidskindefects.TheeyelidmorphologyandtheeyelidResuItsPatientswer
6、efunctionwereobservedaftersurgery.followed-upfor6to24monthspostoperatively,thehardpalatemucosalgraftsandtheflapsexistedwe11inal1patients,theeyelidmorphologyandfunctionbasicallyrecovered,eyelidshadfreedomactivity,closedwell,nocontracture,noinverledorevertedeyelidsdeformity,norelapse.Con
7、clusionCombininggraftingofhardpalatemucosaand(includingtheskin,thetarsalandtheconjunctiva)afterremovalofmalignanttumors,whichasaone-stageoperationwithdefiniteandgoodoutcomeisworthpromoting・[Keywords]Hardpalatemucosa;Transplantation;Reconstructionofeyelids眼睑恶性肿瘤最常见的是基底细胞癌、睑板腺癌、鳞状上皮细胞癌