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目的探求治愈率高、美容效果好、损伤少的睑缘基底细胞癌的治疗方法。方法局麻下对21例已设定切除范围的基底细胞癌在距病灶约1 cm处用功率3~5 W的CO2激光对病灶行气化凝固术使至无肉眼可见病灶,并分别在病灶及其切缘基底部取材行组织病理学检查。结果 21例患者随访1年均无复发。2例患者出现明显瘢痕增生,经处理后瘢痕稳定;1例患者因瘢痕挛缩致眼睑外翻而出现轻度眼睑闭合不全和溢泪现象;其余病例均愈合良好无明显并发症。术后1年痊愈率、显效率和有效率分别为85.7%、9.5%和4.8%。1例随访至4年时发现肿瘤复发入院治疗,无一例死于基底细胞癌复发。结论 CO2激光治疗早期睑缘基底细胞癌术后患者伤口恢复良好,睑板功能基本正常,美容效果佳,复发率低。
Objective To explore the treatment of eyelid basal cell carcinoma with high cure rate, good cosmetic effect and less damage. Methods Twenty-one cases of basal-cell carcinoma with resection range under local anesthesia were treated with CO2 laser with power of 3 ~ 5 W at a distance of about 1 cm from the lesion. And the base of its margins taken histopathological examination. Results 21 patients were followed up for 1 year without recurrence. Two patients had obvious scar hyperplasia, and the treated scar was stable. One patient had eyelid eversion because of scar contracture, and had slight eyelid insufficiency and overflowing tears. The rest of the cases healed well without obvious complication. One year after operation, the cure rate, effective rate and effective rate were 85.7%, 9.5% and 4.8% respectively. One case was followed up to 4 years and found that the tumor recurred hospitalized, none of them died of basal cell carcinoma recurrence. Conclusion CO2 laser treatment of early eyelid basal cell carcinoma in patients with good wound recovery, meibomian function was normal, good cosmetic results, low recurrence rate.