中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2012年
2期
131-134
,共4页
角膜溃疡,蚕蚀性%手术切除%冷凝
角膜潰瘍,蠶蝕性%手術切除%冷凝
각막궤양,잠식성%수술절제%냉응
Corneal ulcer,Mooren's%Surgical excision%Cryocoagulation
目的 探讨手术切除角膜结膜病灶组织联合二氧化碳直冷凝术治疗蚕蚀性角膜溃疡的效果.方法 对16例(17眼)通过手术切除溃疡周围球结膜和角膜病灶组织,实施二氧化碳直冷式冷凝,辅以免疫抑制剂等药物治疗,直至角膜溃疡修复、愈合,随访1～5年.结果 本组在治疗中,均未发生病情加重或感染情况,有7眼经一次联合治疗治愈,4眼多次冷凝后治愈,4眼出现病情反复,经再次联合治疗后,病情控制未再复发.2眼先后复发,行“角巩膜板层移植”手术治疗.结论 手术切除角膜结膜病灶组织联合二氧化碳冷凝治疗蚕蚀性角膜溃疡效果良好.关键是彻底清除溃疡周围病灶组织,冷凝时要掌握适度的温度、时间、次数.
目的 探討手術切除角膜結膜病竈組織聯閤二氧化碳直冷凝術治療蠶蝕性角膜潰瘍的效果.方法 對16例(17眼)通過手術切除潰瘍週圍毬結膜和角膜病竈組織,實施二氧化碳直冷式冷凝,輔以免疫抑製劑等藥物治療,直至角膜潰瘍脩複、愈閤,隨訪1～5年.結果 本組在治療中,均未髮生病情加重或感染情況,有7眼經一次聯閤治療治愈,4眼多次冷凝後治愈,4眼齣現病情反複,經再次聯閤治療後,病情控製未再複髮.2眼先後複髮,行“角鞏膜闆層移植”手術治療.結論 手術切除角膜結膜病竈組織聯閤二氧化碳冷凝治療蠶蝕性角膜潰瘍效果良好.關鍵是徹底清除潰瘍週圍病竈組織,冷凝時要掌握適度的溫度、時間、次數.
목적 탐토수술절제각막결막병조조직연합이양화탄직냉응술치료잠식성각막궤양적효과.방법 대16례(17안)통과수술절제궤양주위구결막화각막병조조직,실시이양화탄직랭식냉응,보이면역억제제등약물치료,직지각막궤양수복、유합,수방1～5년.결과 본조재치료중,균미발생병정가중혹감염정황,유7안경일차연합치료치유,4안다차냉응후치유,4안출현병정반복,경재차연합치료후,병정공제미재복발.2안선후복발,행“각공막판층이식”수술치료.결론 수술절제각막결막병조조직연합이양화탄냉응치료잠식성각막궤양효과량호.관건시철저청제궤양주위병조조직,냉응시요장악괄도적온도、시간、차수.
Objective To discuss the efficacy of surgical excision of corneal and conjunctival lesions combined with carbon dioxide cryotherapy for the treatment of Mooren's ulcer.Methods 16 cases ( 17eyes) were underwent surgical excision of corneal lesions and conjunctival tissues adjacent to ulcer,followed with carbon dioxide cryotherapy,immunosuppressive agents were administered until the ulcer healed.All the cases were followed up for 1 to 5 years.Results None of the cases had infection and deterioration during therapy.7 cses (7 eyes) cured after combined therapy once,cryotherapy 4cases(4eyes) cured after repeated carbon dioxide cryotherapy 4cases (4 eyes) appeared to recurrent attacks,yet no recurrence was detected after repeated combined therapy.2 eyes appeared to recurrent attacks,and accepted the corneoscleral lamellar graft.Conclusion The surgical excision of corneal and conjunctival lesions combined with cryotherapy is effective to treat Mooren's ulcer.The key procedure is excising the lesion tissues completely and mastering the appropriate temperature,time and frequency in cryotherapy.
