814中南大学学报‘劈学版)20lo，35(8)hapJC：／／】【hy】【．xy哪．netentSouthUn／v(Medsd)““’“、。777～7⋯J⋯⋯ImprovedconjunctivaltransplantationforcornealulcerZHOUQinghua，LONGXianhua，ZHUXiaohua(DepartmentofOphthalmology，SecondXiangyaHospital，CentralSouthUniversity，Changsha410008，China)Abstract：ObjectiveToevaluatethetherapeuticeffectofpedicalconjunctivalflaptranspositiononrefractorycomealulcer．MethodsThedataof56eyesof56patientswithrefractorycornealulcerwhounderwentpedicalconjuetivaltranspositioninatertiaryeyeunitinChinafromJune2005toJune2009wereretrospectivelyanalyzed．Therewere36infectivecornealulcers，9keratoplastygraftulcers，4traumaticulcers．and7chemicalburnulcers．AUpatientsweretreatedwithfocaldebridementandpedi·calconjuctivalflaptransposition．ResultsForty—sevenoutof56(83．9％)werecuredafteronesurgery，and5(8．9％)hadconjunctivalflapretraction，amongwhich3underwentthesecondsurgeryand2hadthethirdsurgerytocompletelyheal．Fourpatients(7．2％)turnedtolamellarkeratoplastybe—causeoffungalcornealulcerrelapse．Ulcerin52patientshealedandtheglobepreserved．Theyhaddif-ferentlevelsofvisionimprovement．ConclusionPedicalconjunetivalflaptranspositioniseffectiveforrefractorycornealulcer．Keywords：conjunctivaltransplantation；operation；cornealulcer改良结膜瓣移植治疗角膜溃疡周清华，龙先花，朱小华(中南大学湘雅二医院眼科，长沙410008)[摘要】目的：观察应用带蒂结膜瓣转位遮盖术治疗难治性角膜溃疡的临床疗效。方法：回顾性分析2005年6月至2009年6月在湘雅二医院行带蒂结膜瓣转位遮盖术治疗的56例56眼，其中感染性角膜溃疡36眼，角膜移植术后植片溃疡9眼，外伤致角膜溃疡4眼，化学伤致角膜溃疡7眼，均采用了痛灶清除联合带蒂结膜瓣转位遮盖术。结果：47例(83。9％)患者一次手术治愈，5例(8．9％)出现结膜辨回退，3例行再次手术后治愈，2例患者行3次结膜瓣手术获得治愈，4例(7．2％)由于真菌性角膜溃疡复发改行板层角膜移植术。52眼(92．9％)经采用带蒂结膜瓣转位遮盖术治愈角膜溃疡保全眼球，获得不同程度的视力增加。结论：带蒂结膜辩转位遮盖术仍是有效的临床治疗手段。[关键词】结膜移植；手术；角膜溃疡DOI：10．3969／j．issn．1672-7347．2010．08．007Dateof删帅2010—05—10BiographyZHOUQinghua，M．D．，Attendingphysician。mainlyengage(1inclinicalandfundamentalresearchofcem咖Ⅲ8．CorrespondingauthorZHOUQingIlM，E-mail：zhqhl975@yahoo．corn．cn万方数据ImprovedconjunctivaltransplantationforcornealulcerZHOUQinghua，etal815RefractoryC01Tlealulcersremainsarealclini-calchallenge，includingchronicasepticinflamma-tion，severechemicalburn，persistentbacterial，fungalorviralinfections，inappropriatepost-traumaticsutureddrugs，andulcersofimplantorrecipientbedaftercornea]transplantation．Drugtreatmentalonecanhardlycontrolthecornealulcer，thusmakingclinicaldecisionmoredifficultforophthalmologists．Pedicalconjunetivalflaptransplantationisaclassicsurgicaltreatmentforcornealulcers‘1J，andstillhasthewidespreadapplicationinclinicalpracticeinChi-na．Inthisstudy，therecordsof56eyesof56ca-8espresentingwithrefractorycornealulcerwhoun—derwentpedicalconjuctivaltransplantationinatertia-ryeyeunitinChinafromJune2005toJune2009werereviewedinaretrospectiveinterventionalcaseseries．Theaimofthisstudywastoevaluatethetherapeuticeffectofpedicaleonjunctivalflaptrans-plantationonrefractorycornealulcer．1MATER认LSANDMETHoDS1．1DemographicfeaturesAltogether56eyesof56casesincluding37malesand19femaleswithrefractorycornealulceragingfrom19to61(34．45average)wereretro...
