CAJ | 학술논문

目的：探讨颜面部钙化上皮瘤的有效切除范围及缩小手术切口的疗效和临床意义。方法2012年1月至12月我们收治颜面部单发钙化上皮瘤39例，手术切除范围包括包膜内肿物切除、肿物连同包膜完整切除、包膜外1～2 mm 切除、全层皮肤连同肿物挖除（2～4 mm），手术方式为普通切口，设为普通切口组；2013年1月至12月收治颜面部单发钙化上皮瘤45例，切除范围包括包膜内切除、连同包膜完整切除，手术方式为微小切口，设为微小切口组。比较两组肿物最大直径和切口长度，并从病理特点探讨其有效切除范围的依据。结果两组84例均恢复良好，无一例复发。病理特点：钙化上皮瘤瘤体周边界限清晰，其包膜完全为纤维结缔组织假性包膜，无上皮或内皮结构，包膜周边即正常的皮下组织结构，无增殖的瘤细胞。免疫组化：Ki67（－）。两组肿物直径比较，差异无统计学意义（P ＞0.05）；切口长度比较，差异有统计学意义（P ＜0．05）。术后微小切口组瘢痕小，外形美观，患儿及家属满意度高。结论钙化上皮瘤经临床检查即可诊断，术中无需切除过多的组织，只要将钙化团块完全切除即可，采用微创小切口方法，疗效确切，术后瘢痕不明显，外形美观，患者满意度高。
목적：탐토안면부개화상피류적유효절제범위급축소수술절구적료효화림상의의。방법2012년1월지12월아문수치안면부단발개화상피류39례，수술절제범위포괄포막내종물절제、종물련동포막완정절제、포막외1～2 mm 절제、전층피부련동종물알제（2～4 mm），수술방식위보통절구，설위보통절구조；2013년1월지12월수치안면부단발개화상피류45례，절제범위포괄포막내절제、련동포막완정절제，수술방식위미소절구，설위미소절구조。비교량조종물최대직경화절구장도，병종병리특점탐토기유효절제범위적의거。결과량조84례균회복량호，무일례복발。병리특점：개화상피류류체주변계한청석，기포막완전위섬유결체조직가성포막，무상피혹내피결구，포막주변즉정상적피하조직결구，무증식적류세포。면역조화：Ki67（－）。량조종물직경비교，차이무통계학의의（P ＞0.05）；절구장도비교，차이유통계학의의（P ＜0．05）。술후미소절구조반흔소，외형미관，환인급가속만의도고。결론개화상피류경림상검사즉가진단，술중무수절제과다적조직，지요장개화단괴완전절제즉가，채용미창소절구방법，료효학절，술후반흔불명현，외형미관，환자만의도고。
Objetive To explore the effective excision range and curative effect and clinical importance of small-cut operation in pilomatricoma on face.Methods 39 cases diagnosed as pilomatricoma on face in our hospital from Jan.2012 to Dec.2012 were collected.All these cases were divided into two groups including normal incision group and minus incision group.The maximum diameter of the pilomatricoma and the length of incision were compared and the reasons for resection scope were analyzed.Results All the patients recovered very well and no recurrence was found.There was no statistical difference found in diameter (P >0.05),but there was obvious statistical difference in incision length (P <0.05).Patients in minus incision group were satisfied with the incision because the scar was small. Conclutions Pilomatricoma excision is a good effect due to the minus incision caused.Such an operation only need to cut the calcified clumps rather than cutting too much tissue.