眼部碱烧伤超声生物显微镜图像特征研究  

Ultrasound biomicroscopy of eye alkali burn

作　　者：邓宏伟[1] 方玲珠[1] 姚晓明[1] 

机构地区：[1]暨南大学附属深圳市眼科医院,广东省深圳市518001

出　　处：《眼科新进展》2008年第11期835-837,共3页Recent Advances in Ophthalmology

基　　金：广东省医学科研课题基金资助(编号:B2007156)~~

摘　　要：目的应用超声生物显微镜(ultrasound biomicros-copy,UBM)对不同程度碱烧伤患者眼前段结构进行观察,研究图像特征,对烧伤的程度、治疗手段及预后进行评估。方法观察6例12眼碱烧伤急性期患者,临床Ⅱ度烧伤者6眼,Ⅲ度烧伤者4眼,Ⅳ度烧伤者2眼。在烧伤的急性期作UBM检查,检查内容包括前房、房角、后房、睫状体,并将检查结果与临床表现相联系。结果碱烧伤急性期6眼UBM图像均显示有不同程度的前部及中间葡萄膜炎表现,房水混浊,睫状体水肿多见,根据碱烧伤程度和范围不同角膜有不同程度的水肿。UBM表现如下:Ⅱ度碱烧伤图像表现为角膜上皮回声增强,烧伤若累及后弹力层,表现为后弹力层花边样改变,角膜厚度在水肿区明显增厚;Ⅲ度碱烧伤图像表现为角膜上皮缺失区上皮反光带的缺失或不连续,角膜厚度明显增厚,后弹力层出现回声光带不明确以及断裂;Ⅳ度碱烧伤图像表现为角膜正常回声影像完全消失,角膜呈不均匀中强回声,角膜与巩膜相延续部分结构不清,角膜缘后巩膜层水肿明显,巩膜结构呈现不均匀强回声影像。结论UBM可显示不同程度的眼表烧伤后眼前节的情况,严重的碱烧伤不仅造成角膜5层组织不可逆的改变,而且造成眼前节较重的葡萄膜炎表现,导致预后不良。Objective To observe anterior segment structure of eye in patients with alkali burn at various degrees by ultrasound biomicroscopy （UBM）, to evaluate the grade, treatment and prognosis of the disease. Methods Six cases （ 12 eyes） of the alkali burn at various degrees were enrolled in this study. Six eyes were with Ⅱ degree, 4 eyes with Ⅲ degree and 2 eyes with Ⅳ degree. UBM examinations were performed in the acute stage on the anterior chamber, the angle, posterior chamber and ciliary body. And the results were connected with the clinical situation. Results Six eyes displayed in different extent of anterior and medium uveitis. Opacity of aqueous humor and ciliary body edema were common. The degrees of cornea edema were connected ,with the degrees of alkali burn,which were showed in UBM with the epithelium reinforcement of the echo. With UBM examination,the Ⅱ degrees of alkali burn showed that the corneal epithelial echo enhanced. If alkali burn involved the posterior elastic membrane, the performance were lace-like change, corneal thickness significantly thickned area in edema;The Ⅲ degrees of alkali burn showed that corneal epithelial deletion region refletive band performed deletion and discontinuous, and corneal thickness significantly thickened, with echo band discontinuous and vague images of the posterior elastic membrane ;The Ⅳ degrees of alkali bnrn showed that the normal cornea echo images completely disappeared, the cornea with uneven strong echo, the connecting structure of cornea and sclera blurred, edema of limbal scleral layer seemed obviously,and the structure of the selera showed uneven strong echo images. Conclusion UBM can show the condition of anterior segment of eye in different degrees of alkali burn. The severe burn not only can cause the inconvertible change of corneal structure but also cause quite severity of anterior uveitis and poor prognosis.

关 键 词：超声生物显微镜 碱烧伤 眼前段 

分 类 号：R779.2[医药卫生—眼科]