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改良结膜瓣移植治疗角膜溃疡VIP免费

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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...

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改良结膜瓣移植治疗角膜溃疡

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