睑球粘连术后泪膜状况及手术方式探讨  

Tear film status of symblepharon after operation and suitable surgery

作　　者：刘建伟[1] 邓爱军[1] 王杰[1] 贺圣光[1] 王维宏[1] 

机构地区：[1]潍坊医学院附属医院眼科,山东省潍坊市261031

出　　处：《眼科新进展》2011年第12期1168-1170,共3页Recent Advances in Ophthalmology

摘　　要：目的观察不同程度的睑球粘连术后泪膜的状况,探讨不同程度的睑球粘连的手术方式。方法 39例单眼睑球粘连患者,依照粘连程度分为A、B两组,其中A组21例,粘连程度小于1个象限,B组18例,粘连程度大于1个象限,行睑球粘连分离并羊膜移植术,并分别于术后1个月、6个月、12个月观察泪膜破裂时间、泪液分泌试验值、角膜荧光素染色情况,与健眼进行对照比较。结果泪膜破裂时间:A组术后1个月(7.55±5.46)s较健眼(11.84±4.37)s短(P<0.05);术后6个月、12个月分别为(9.31±4.25)s、(10.13±4.71)s,与健眼差异均无统计学意义(均为P>0.05)。B组术后1个月、6个月、12个月泪膜破裂时间(5.22s±4.38s、6.08s±3.29s、6.22s±3.14s)均较健眼(9.76s±3.12s)短(均为P<0.05)。泪液分泌试验值:A组术后1个月(15.23±4.71)mm较健眼(11.75±3.65)mm分泌增多(P<0.05);术后6个月、12个月(13.56mm±3.89mm、13.87mm±3.76mm)与健眼差异均无统计学意义(均为P>0.05)。B组术后1个月(16.78±6.33)mm较健眼(12.13±4.12)mm分泌增多(P<0.05);术后6个月、12个月(8.72mm±3.26mm、8.74mm±3.57mm)较健眼分泌少(均为P<0.05)。角膜荧光素染色:术后1个月A、B两组评分分别为(5.32±3.23)分、(6.15±3.09)分,较健眼(2.07±1.97)分、(2.25±2.06)分均升高(均为P<0.05);术后6个月、12个月A组分别为(2.24±2.01)分、(2.35±2.17)分,B组分别为(2.46±3.11)分、(2.42±2.15)分,与健眼差异均无统计学意义(均为P>0.05)。结论睑球粘连术后早期泪膜不稳定。半年之后,1个象限以内的睑球粘连泪膜功能稳定,超过1个象限的病变泪膜功能受到影响,羊膜联合其他组织移植可能会改善这种情况。Objective To observe the tear film status of different grade symblepharon after operation and find out the suitable surgery for this disease.Methods About 39 patients were divided into two groups according to the symblepharon severity.About 21 cases with the extent of lesion less than one quarter were included in group A,other 18 cases with a more serious lesion than one quarter were in group B.All the patients were treated with segregation and amniotic membrane transplantation surgery.Tear break up time（BUT）,Schirmer I test（SIt） and corneal fluorescence staining（CFS） score were measured at postoperative 1 month,6 months and 12 months.Results In group A,the mean BUT was（7.55±5.46）s,which was significantly lower than（11.84±4.37）s of normal eyes at postoperative 1 month（P0.05）,and the mean BUT were（9.31±4.25）s and（10.13±4.71）s at postoperative 6 months and 12 months,which had no difference with normal eyes（both P0.05）.The mean BUT were（5.22±4.38）s,（6.08±3.29）s,（6.22±3.14）s at postoperative 1 month,6 months and 12 months in group B,which were shorter than（9.76±3.12）s for normal eye（all P0.05）.In group A,the SIt value was（15.23±4.71）mm at postoperative 1 months,more than（11.75±3.65）mm for normal eye（P0.05）,and（13.56±3.89）mm and（13.87±3.76）mm at postoperative 6 months and 12 months,which had no difference with that of normal eye（both P0.05）.In group B,the SIt value was（16.78±6.33）mm at postoperative 1 months,more than（12.13±4.12）mm for normal eye（P0.05）,and（8.72±3.26）mm and（8.74±3.57）mm at postoperative 6 months and 12 months,which had no difference with that of normal eye（both P0.05）.The CFS scores were 5.32±3.23,6.15±3.09 in group A and group B at postoperative 1 month,higher than 2.07±1.97,2.25±2.06 for normal eyes（both P0.05）,2.24±2.01,2.046±3.11 at postoperative 6 months,and 2.35±2.17,2.42±2.15 at postoperative 12 months,which had no difference with normal eyes（all P0.05）.Conclus

关 键 词：睑球粘连 泪膜 羊膜移植 

分 类 号：R779.6[医药卫生—眼科]