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目的观察肿瘤病灶清除联合冷冻及羊膜移植术治疗Bowen氏病的临床疗效。方法回顾我院临床诊断为Bowen氏病10例(10眼)患者,均行肿瘤病灶清除,同时对肿瘤粘连最明显的角巩缘处行短时间(20秒)、多点的冷冻处理,切除的结膜部分和角膜创面行羊膜覆盖。术后观察创面的上皮愈合,眼表的稳定及肿瘤的复发情况和其它并发症。切除的肿瘤均行组织病理检查以明确诊断。结果10例患者中病理结果8例为上皮内上皮癌(Bowen氏病),2例为鳞状上皮细胞癌。所有患者随访均超过半年,术后两w内手术区角结膜上皮修复完整。2例患者可见浅层角膜新生血管长入,余未见并发症。随诊期间9例患者未见复发,1例患者术后5m,在角巩缘发生复发,故再次行肿瘤切除,冷冻联合羊膜移植术,继续随诊超过半年未见复发。结论肿瘤病灶清除联合冷冻及羊膜移植术是治疗Bowen氏病的较为理想的手术方法。
Objective To observe the clinical effect of tumor debridement combined with freezing and amniotic membrane transplantation in the treatment of Bowen’s disease. Methods A retrospective study of 10 cases (10 eyes) with Bowen’s disease in our hospital was performed to remove tumor lesions. At the same time, short-time (20 seconds), more freezing treatment and resection The conjunctiva portion and corneal wound were covered with amniotic membrane. Postoperative wound healing observed epithelial, ocular surface stability and tumor recurrence and other complications. Excised tumors were histopathologically examined to confirm the diagnosis. Results The pathological findings of 10 patients were epithelial intraepithelial neoplasia (Bowen’s disease) and 2 were squamous cell carcinoma. All patients were followed up for more than six months, two weeks after surgery, the surgical area of the conjunctiva epithelial repair complete. 2 patients showed superficial corneal neovascularization, I did not see complications. No recurrence was observed in 9 cases during the follow-up. One case had recurrence at the corner and margin after 5 months. Therefore, resection and cryosurgery combined with amniotic membrane transplantation were performed again. No recurrence was found after more than six months follow-up. Conclusion Tumor debridement combined with cryoablation and amniotic membrane transplantation is an ideal surgical treatment of Bowen’s disease.