结膜瓣遮盖术治疗难治性角膜溃疡的临床疗效  

Clinical Curative Effect of Conjunctival Flap Covering Surgery in Treatment of Refractory Corneal Ulcer

作　　者：王莹婷[1] 胡竹林[1] 刘海[1] 张文佳[1] 柯红琴[1] 李妍[1] WANG Ying-ting;HU Zhu-lin;LIU Hai;ZHANG Wen-jia;KE Hong-qin;LI Yan(Department of ophthalmology,Yunan Second Hospital,Kunming,Yunnan Province,650021 China)

机构地区：[1]云南省第二人民医院眼科,云南昆明650021

出　　处：《系统医学》2017年第17期18-20,共3页Systems Medicine

摘　　要：目的探讨和分析结膜瓣遮盖术治疗难治性角膜溃疡的临床疗效。方法研究选择2015年6月—2017年5月间在云南省第二人民医院进行治疗的86例(86眼)难治性角膜溃疡患者当做研究对象,遵循患者入院顺序分甲组和乙组,每组43例(43眼),乙组患者进行病灶切除,而甲组患者通过结膜瓣遮盖术进行治疗,并按患者的角膜溃疡位置、是否角膜穿孔来进行不同手术,总结甲乙两组患者的治疗效果以及视力变化情况。结果乙组患者治疗的总有效率(58.14%)小于甲组患者(95.53%),对比差异有统计学意义(P<0.05)。甲组患者术后视力小于0.02的发生率(23.26%)、视力在0.02~0.05间的发生率(18.60%)、视力在0.06~0.09间的发生率(30.23%)、视力在0.1~0.3间的发生率(18.60%)、视力在超过0.3的发生率(9.30%)明显优于乙组患者[44.19%、39.53%、11.63%、4.65%、0.00%],对比差异有统计学意义(P<0.05)。结论在临床上治疗难治性角膜溃疡使,结膜瓣遮盖术的应用效果确切,可控制炎症和保留患者的眼球,并改善视力,应推广使用。Objective To study and analyze the clinical curative effect of conjunctival flap covering surgery in treatment of refractory corneal ulcer.Methods 86 cases(86 eyes)treated in our hospital from June 2015 to May 2017 were selected as the research objects and divided into two groups with 43 cases in each according to the admission order,the group B and the group A were respectively treated with lesion resection and conjunctival flap covering surgery,and the operations were performed according to the position of keratohelcosis and corneal perforation or not,and the treatment effect and changes of visions of the two groups were compared.Results The total effective rate in the group B was less than that in the group A,(58.14%vs 95.53%),and the difference was statistically significant(P<0.05),and the incidence rates of postoperative vision less than 0.02,between 0.02 and 0.05,between 0.06 and 0.09,between 0.02 and 0.05,between 0.06 and 0.09,between 0.1 and 0.3 and more than 0.3 were obviously better than those in the group B,(23.26%,18.60%,30.23%,18.60%,9.30%vs 44.19%,39.53%,11.63%,4.65%,0.00%),and the differences were statistically significant(P<0.05).Conclusion The application effect of conjunctival flap covering surgery in treatment of refractory corneal ulcer can control the inflammation and reserve the eyeball and improve the visions,and it is worth promotion and application.

关 键 词：难治性角膜溃疡 结膜瓣遮盖术 临床疗效 

分 类 号：R772.21[医药卫生—眼科]