羊膜移植联合羊膜覆盖治疗角膜结膜原位癌(Bowen病)临床效果  

The Clinical Effect of Amniotic Membrane Transplantation and Covering for Corneal Conjunctival Carcinoma in Situ (Bowen's Disease)

作　　者：郭健华 GUO Jian-hua(Department of Ophthalmology,Central Hospital of Anshan,Anshan 114000,Liaoning,China)

机构地区：[1]辽宁省鞍山中心医院眼科,鞍山114000

出　　处：《中国现代手术学杂志》2018年第6期469-471,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨羊膜移植联合羊膜覆盖治疗角膜结膜原位癌(Bowen病)的临床效果,总结显微手术经验,为Bowen病手术优化提供参考。方法选择2015年1月～2016年12月我院收治的45例(45眼) Bowen病患者,显微镜下行羊膜移植联合羊膜覆盖治疗,观察创面上皮愈合及复发情况,统计手术成功率,术后行视力检查。结果 45例(45眼)患者均顺利完成手术,术后羊膜移植片与角膜、巩膜表面贴合良好,未见出血及感染。所有患者2周内上皮完全愈合,术后随访1年未见复发。所有患者均获得手术成功,手术成功率为100. 0%。39例(39眼)患者术后视力均有不同程度提高,6例(6眼)视力保持不变。术后平均视力(0. 65±0. 20)显著优于术前(0. 45±0. 25),差异有统计学意义(t=17. 682,P=0. 000)。结论羊膜移植联合羊膜覆盖治疗Bowen病疗效确切,可不同程度改善患者视力,是治疗Bowen病的有效方法。Objective To investigate the clinical effect of amniotic membrane transplantation combined with amniotic membrane covering in the treatment of Bowen’s disease,summarize the microsurgical skills,and provide reference for the optimization of Bowen’s disease. Methods A total of 45 patients( 45 eyes) with Bowen’s disease treated by amniotic membrane transplantation and covering under microscope were retrospectively analyzed from January 2015 to December 2016. The healing of epithelium and recurrence of Bowen’s disease were observed. The success rate of operation was recorded and visual acuity was examined after operation.Results All the 45 patients( 45 eyes) completed the operation successfully. The surface of the amnion graft were well adhered to the surface of the cornea and sclera after operation,and no bleeding or infection was found. The epithelium healed completely within 2 weeks. No recurrence was observed during one year followup. All the operations were successful with the success rate of 100. 0%. Postoperative visual acuity was improved in 39 patients( 39 eyes),and remained unchanged in 6 patients( 6 eyes). The average visual acuity was 0. 65 ± 0. 20,and significantly better than 0. 45 ± 0. 25 before the operation,and the difference was significant( t = 17. 682,P = 0. 000). Conclusion The surgical intervention of amniotic membrane transplantation combined with amniotic membrane covering is an ideal and effective treatment for Bowen’s disease,which can improve the visual acuity of patients in varying degrees.

关 键 词：角膜结膜原位癌 羊膜移植 羊膜覆盖 显微手术 

分 类 号：R739.7[医药卫生—肿瘤]