【摘要】 目的 觀察應用不同手術方法矯正麻風麻痹性下瞼外翻的療效。 方法 2006年10月-2009年11月,共收治麻風麻痹性下瞼外翻68例115眼,根據患者下瞼外翻程度和局部專科情況,分別采用顳肌移位+闊筋膜移位懸吊固定術(Johnson法),改良顳肌移位術,下瞼板縮短外眥韌帶懸吊固定術,眼輪匝肌島狀皮瓣,眼輪匝肌懸吊固定術以及絲線懸吊固定術矯正眼瞼外翻。 結果 68例115眼成功率98.9%,手術后由于下瞼外翻導致的各種合并癥明顯好轉。隨訪觀察4~11個月所有患者術后效果良好,無復發。 結論 麻風麻痹性下瞼外翻的手術治療應根據患者的不同情況選擇合適的手術方法,才能達到最佳的矯正效果。【Abstract】Objective To evaluate the clinical effect of different surgical methods to correct lower eyelid paralytic ectropion. Methods From October 2006 to November 2009, 68 cases (115 eyes) with lower eyelid paralytic ectropion induced by leprosy were treated in this department.According to the degree and local circumstance of different patients, some patients underwent temporalis muscle transfer (TMT) with the Johnson’s procedure, some patients underwent modified temporalis muscle transfer, and some patients underwent orbicularis oculi muscle island flap or uplifting the lower eyelids with orbicularis oculi muscle, silk, lateral canthal tendon. Results The achievement rate of 68 cases (115 eyes) was 98.9%.The complications resulted from lower eyelid ectropion were obviously improved.All the patients got good results followed up for 4 months to 11 months after operation and no recurrence was found. Conclusion To achieve the best effect of correcting lower eyelid paralytic ectropion, it is the key point to choose the suitable method according to the level and local circumstance.
OBJECTIVE: To investigate the clinical effects of repairing skin defect after resection of cutaneous malignant tumors. METHODS: From 1984 to 2001, cutaneous malignant tumors of 38 patients were resected and diagnosed pathologically. There were 12 cutaneous squamous cancer, 14 carinal cutaneous fibrosarcomas, 2 in situ cancers, 1 wart like cancer, 4 eczematoid cancers, and 5 deteriorative chronic ulcers. The biggest skin defect was 14 cm x 20 cm in size. Skin defects were repaired with flaps, myocutaneous flaps, free skin grafts and suturations. There were 4 gastronomies flaps, 6 latissimus flaps, 2 tensor fascia lata myocutaneous flaps, 1 transverse recuts abdominis myocutaneous flap, 5 plantaris medialis flaps, 3 random flaps, 12 free skin grafts and 5 suturings. RESULTS: All the operations succeed. Among 21 cases followed up for 3 to 12 years, 19 healed and 2 relapsed, but the 2 patients healed after second operation. CONCLUSION: Thorough resection of tumor is the key to eradicate malignant tumor. The method to repair skin defect after resection should be chosen according to the patients individually.