辅用丝裂霉素的巩膜暴露法翼状胬肉手术  

Excision of pterygium with sclera uncovered and using mitomycin.

作　　者：刘名皎[1] 王开丽[1] 

机构地区：[1]海南省人民医院眼科,海口570311

出　　处：《眼外伤职业眼病杂志》2007年第2期124-125,共2页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的 探讨辅用抗增生药物的简便有效的胬肉手术方法。方法 手术中先切除胬肉头部,尽量切除干净并使剖切面浅而平滑。再分离切除胬肉体部,先在胬肉颈部上下缘剪开结膜5mm,使呈瓣状,用血管钳提起胬肉体部在结膜下分离到泪阜处即剪除。留下的结膜尽可能薄而不破。用一块经0.04%丝裂霉素溶液浸泡过的棉片,填压在结膜下3分钟,然后用20mL生理盐水充分冲洗。形成扇形的无结膜的巩膜暴露区,约4mm×6mm。此暴露区无需任何原位或转位结膜瓣缝合覆盖。彻底止血后加压包盖。术后2-3天检查,角膜创面大部分已无荧光素着色。1-2周结膜创面愈合。结果 随访3月以上,128眼中复发7眼,占5.47%;有复发倾向者2眼,占1.56%;无复发者121眼,占94.53%。无复发的眼术侧睑裂部球结膜菲薄,血管稀少,而且结膜薄白美观。结论 术中及术后适度用丝裂霉素,术中尽量切净胬肉,并切除结膜,裸露巩膜扇形区,不作原位或转位结膜瓣缝合覆盖,此法明显地降低胬肉手术的复发率,并简化了手术步骤。Objective To observe a simple and effective excision of pterygium with an assistant drug-mitomycin. Methods The head of pterygium was cutted and the incisal surface was maked shallow and smooth,then the body of pterygium was cutted and snip the conjunctiva about 5mm at the neck of pterygium. Later all the pterygium was cutted. The rest of conjunctiva should as thin as possible but shouldn＇t be broken. We put cotton pellets which were dipped in 0.04% mitomycin solution on conjunctiva about 3 minutes, then douche conjunctival sac by 20 ml isotonic Na chloride. The district of uncovered sclera looks like a 4mm × 6mm sector and needn＇t be covered by conjunctiva. We covered the eye after hemostasis thoroughly. There was no fluorescein on cornea 2-3 days postoperatively. 1-2 weeks later,we found wound surface of conjunctiva had healed. Results Following over 3 months, the result showed 121 eyes（94.53% ） didn＇t recur;7 eyes recurred,Conjunctiva were thin,white and beautiful in no recurred eyes. Conclusions The surgery can reduce the rate of recurrence of excision of pterygium if we use some mitomycin in the operation and postoperative,meanwhile, cut off conjunctiva without suturing conjunctival flap. Also the steps of this method are simple.

关 键 词：翼状胬肉 手术 丝裂霉素 巩膜暴露 

分 类 号：R779.6[医药卫生—眼科]