硬腭黏膜游离移植在全层眼睑缺损修复中的应用  

Application of hard palate mucosa free grafting in the reconstruction of fuli-thickness eyelid defects

作　　者：韩新鸣[1] 郑永生[1] 孙强[1] 马涛[1] 戴利[1] 张君毅[1] 许莲姬[1] 

机构地区：[1]首都医科大学附属北京同仁医院整形美容中心,北京100730

出　　处：《中国美容整形外科杂志》2014年第9期558-561,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨硬腭黏膜游离移植在修复中、重度全层眼睑缺损中的应用效果。方法首先根据睑板的缺损范围切取硬腭黏膜，行游离移植修复眼睑后层（睑板结膜层），再依据眼睑软组织的缺损部位和范围设计皮瓣，并转移皮瓣修复。结果本组共198例患者（198只眼）。其中上睑58例，下睑131例，上下睑联合缺损9例；硬腭移植面积最小10mm×5mm，最大35mm×20mm。术后随访3—24个月，硬腭黏膜均成活良好，无明显回缩，眼球未见损伤，眼睑外观及功能改善满意。1例眼轮匝肌蒂皮瓣远端2／3坏死，术后2周采用局部皮瓣修复，1个月后随访发现硬腭黏膜完全成活。结论对中、重度全层眼睑缺损的衬里修复采用硬腭黏膜游离移植，手术操作简便，易成活，远期效果肯定。Objective To investigate the outcomes of hard palate mucosa free grafting in the reconstruction of full-thickness eyelid defects. Methods In the process of this operation, a piece of hard palate mucosa was harvested according the tarsus defect size firstly, and then the free grafting of hard palate mucosa was finished to reconstruct posterior layer （tarsus-conjunctiva layer） of the eyelid. Then flap was designed and transferred to the soft tissue defect according the location and range of the soft tissue defect. Results The total 198 patients （198 eyes） with full-thickness eyelid defects （58 upper eyelids, 131 lower eyelids, 9 combined defects） had been reconstructed by free grafting of hard palate mucosa and flaps. The size of the hard palate mucosa graft ranged from 10 mm ×5 mm to 35 mm×20 mm. All 198 cases were satisfied with eyelid contour and improved functions and without retraction and eyeball injure, except for I case with flap necrosis on the 2/3 are- a of the remote flap which was repaired by local flap at 2 weeks postoperatively, the hard plate mucosa survived well at one month. Conclusion The free grafting of hard palate mucosa to reconstruct moderate and severe full-thickness eyelid defects was easy to handle and survive and the outcome was satisfactory.

关 键 词：硬腭黏膜 移植 全层眼睑缺损著者文摘 

分 类 号：R622[医药卫生—整形外科]