改良肌锥内羟基磷灰石义眼台植入术的效果  

Observation of modified hydroxyapatite orbital implantation in muscular cone

作　　者：杨砚亭 张逸 刘燕[1] YANG Yanting;ZHANG Yi;LIU Yan(Department of Ophthalmology,the First People's Hospital of Changzhou,Changzhou,Jiangsu,213000,China)

机构地区：[1]常州市第一人民医院眼科,江苏常州213000

出　　处：《当代医学》2024年第14期110-113,共4页Contemporary Medicine

基　　金：常州市“十四五”卫生健康高层次人才培养工程-拔尖人才资助项目(KY20221475);常州市应用基础研究计划-面上项目(CJ20230059)。

摘　　要：目的探讨改良肌锥内羟基磷灰石(HA)义眼台植入术的手术难度及疗效。方法选取2016年1月至2020年5月于常州市第一人民医院眼科行眼内容物剜除联合HA义眼台植入手术的49例患者(49眼)作为研究对象,按手术方法不同分为A组(n=37,37眼)与B组(n=12,12眼)。A组采用改良肌锥内HA义眼台植入术,B组采用传统巩膜壳内HA义眼台植入术。统计分析眼内容物剜除病因,比较两组手术时间、术后外观优良率、术后并发症发生情况及手术前后心理状况。结果49例患者中,绝对期青光眼是眼内容剜除术的主要病因(32.7%),其次为眼球萎缩(26.5%)、眼球破裂伴眼内容物丢失(24.5%)、严重角膜溃疡或眼内炎(10.2%)、角膜白斑(4.1%)及角巩膜葡萄肿(2.0%)。A组手术时间为60.0(50.0,70.0)min,明显短于B组的60.0(40.0,80.0)min,差异有统计学意义(P<0.05)。两组术后义眼台均饱满,与结膜愈合良好;两组术后外观优良率比较差异无统计学意义。两组均未出现义眼台暴露、移位及义眼台感染等严重手术并发症;A组术后眼干及眼窝分泌物增多发生率为8.1%,B组为0.0%,组间比较差异无统计学意义。术后,两组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均低于术前,差异有统计学意义(P<0.05),但两组间比较差异均无统计学意义。结论与传统巩膜壳内HA义眼台植入术相比,改良肌锥内HA义眼台植入术操作更简便,手术时间更短,且未发生严重并发症,值得临床推广应用。Objective To investigate the surgical difficulty and efficacy of modified hydroxyapatite(HA)orbital implantation in muscle cone.Methods 49 patients(49 eyes)who underwent evisceration of ocular contents combined with HA orbital implantation surgery in the department of Ophthalmology of the First People's Hospital of Changzhou from January 2016 to May 2020 were selected as the research subjects,they were divided into the group A(n=37,37 eyes)and the group B(n=12,12 eyes)according to the different surgical methods.Group A was treated with modified HA orbital implantation in muscle cone,and the group B was treated with traditional HA orbital implantation in scleral shell.The causes of eviscera-tion of eye contents were statistically analyzed,the operation time,postoperative appearance excellent and good rate,the incidence of postoperative complications,and psychological status before and after operation were compared between the two groups.Results Among 49 patients,absolute glaucoma was the main cause of of evisceration(32.7%),followed by eyeball atrophy(26.5%),ocular rupture with ocular content loss(24.5%),severe corneal ulcer or endophthalmitis(10.2%),corneal leukoplakia(4.1%),and corneoscleral staphyloma(2.0%).The operative time in the group A was 60.0(50.0,70.0)min,which was significantly shorter than 60.0(40.0,80.0)min in the group B,the difference was statistically significant(P<0.05).After operation,the orbital implants of the two groups were full and healed well with the conjunctiva;there was no significant difference in the excellent and good rate of postoperative appearance between the two groups.There were no serious surgical complications such as exposure,displacement and infection of the prosthesis in two groups;the incidence of eye dryness and increased eye socket secretions was 8.1%in the group A and 0.0%in the group B,and there was no statistical significance between the two groups.After operation,the SAS and SDS scores of the two groups were lower than those before operation,and the difference was st

关 键 词：眼内容物剜除术 羟基磷灰石 术后并发症 

分 类 号：R779.6[医药卫生—眼科]