眼表热化学烧伤后重度睑球粘连的疗效观察  

Effect observation on severe symblepharon after chemical and thermal burns on ocular surface

作　　者：赵茂竹[1] 林伟[1] 张杰 

机构地区：[1]四川省医学科学院,四川省人民医院眼科,成都610101 [2]四川省成都市药品不良反应监测中心,成都610042

出　　处：《中国中医眼科杂志》2015年第1期28-31,共4页China Journal of Chinese Ophthalmology

摘　　要：目的观察羊膜和唇黏膜移植,必要时联合口腔修复膜移植治疗眼表热化学烧伤后严重睑球粘连和结膜穹窿再建的临床疗效。方法 15例眼表热化学烧伤后重度睑球粘连病例,均为严重睑球粘连,视力丧失,所有病例均在分离睑球粘连后,形成结膜穹窿,采用唇黏膜及羊膜移植必要时植入口腔修复膜修复睑结膜和球结膜缺损;术后放入义眼片,上下睑缘临时缝合,并加压包扎2周限制眼睑活动。观察移植唇黏膜的成活情况,结膜囊深度及眼球活动度。结果术后随访6~12个月,15例患者中,13例结膜穹窿解剖深度与对侧健眼对称,无粘连和瘢痕形成;2例患者经多次术后睑球仍粘连,穹窿消失,疗效差。结论羊膜和唇黏膜移植必要时移植口腔修复膜能有效矫正眼表热化学烧伤后严重睑球粘连并重建结膜穹窿,能较好的满足患者的外观需求。OBJECTIVE To observe the clinical effect of lip mucosa and amniotic membrane transplantation and necessary transplantation of prosthodontics membrane in the treatment of severe symblepharon and conjunctival fornix reconstruction after chemical and thermal burns on ocular surface. METHODS Fifteen patients（15 eyes）with severe symblepharon after chemical and thermal burns on ocular surface were collected,all patients were severe symblepharon、Visual loss. After relief of symblepharon,palpebral conjunctiva and bulbar conjunctiva defects were reconstructed by lip mucosa and amniotic membrane transplantation,necessary transplantation of prosthodontics membrane. Orbital implant was enchased and Palpebral movement was restricted within two weeks after surgery.Survival condition of lip mucosa. conjunctival sac depth and Eyeball activity were observedafter surgery. RESULTS After 6 to 12 months of followed-up visit,13 patients,with the same depth of fornix as the healthy eye,had adhesion and scar,while 2 patients had recurrence of symblepharon,and disappearance of fornix. CONCLUSIONS Lip mucosa and amniotic membrane transplantation necessary transplantation of prosthodontics membrane could be correct-ed availably in relief of severe symblepharon and reconstruction of fornix after chemical and thermal burns on ocular surface,and also could satisfy patients＇ esthetic need.

关 键 词：唇黏膜移植 羊膜移植 热化学烧伤 睑球粘连 穹窿重建 

分 类 号：R779.13[医药卫生—眼科]