中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2014年
9期
1110-1112
,共3页
翼状胬肉术后%巩膜融解%手术因素与免疫反应组织修复障碍%合理用药治疗
翼狀胬肉術後%鞏膜融解%手術因素與免疫反應組織脩複障礙%閤理用藥治療
익상노육술후%공막융해%수술인소여면역반응조직수복장애%합리용약치료
After pterygium surgery%Scleral melting%Operation factors and immune response to tissue repair disorder%Rational use of drug treatment
目的 分析翼状胬肉切除术后发生巩膜融解并发症的原因和治疗.方法 回顾性分析2008年8月至2013年5月在大理州人民医院眼科行翼状胬肉切除联合自体角膜缘干细胞移植的5例患者出现巩膜融解并发症的临床表现,并对该5例患者行血清学检查,于巩膜坏死区取材涂片及培养.治疗处置为首先停用典必舒眼药水,然后给予促进组织修复的贝复舒或重组人表皮生长因子眼液点眼,待有血管长入巩膜融解区时停用;其中2例巩膜深层融解范围较大行带蒂结膜瓣转位修复.结果 5例患者取材培养均未见微生物生长.其中3例药物治疗2～3周于巩膜融解处可见血管及纤维组织生长,并逐渐有球结膜上皮组织覆盖;2例带蒂结膜瓣转位修复愈合良好.结论 手术因素、自体免疫反应或超敏反应、眼表组织修复障碍,是导致翼状胬肉切除术后巩膜融解的主要原因.减少手术创伤与合理用药,可有效治疗和预防巩膜融解并发症的发生.
目的 分析翼狀胬肉切除術後髮生鞏膜融解併髮癥的原因和治療.方法 迴顧性分析2008年8月至2013年5月在大理州人民醫院眼科行翼狀胬肉切除聯閤自體角膜緣榦細胞移植的5例患者齣現鞏膜融解併髮癥的臨床錶現,併對該5例患者行血清學檢查,于鞏膜壞死區取材塗片及培養.治療處置為首先停用典必舒眼藥水,然後給予促進組織脩複的貝複舒或重組人錶皮生長因子眼液點眼,待有血管長入鞏膜融解區時停用;其中2例鞏膜深層融解範圍較大行帶蒂結膜瓣轉位脩複.結果 5例患者取材培養均未見微生物生長.其中3例藥物治療2～3週于鞏膜融解處可見血管及纖維組織生長,併逐漸有毬結膜上皮組織覆蓋;2例帶蒂結膜瓣轉位脩複愈閤良好.結論 手術因素、自體免疫反應或超敏反應、眼錶組織脩複障礙,是導緻翼狀胬肉切除術後鞏膜融解的主要原因.減少手術創傷與閤理用藥,可有效治療和預防鞏膜融解併髮癥的髮生.
목적 분석익상노육절제술후발생공막융해병발증적원인화치료.방법 회고성분석2008년8월지2013년5월재대리주인민의원안과행익상노육절제연합자체각막연간세포이식적5례환자출현공막융해병발증적림상표현,병대해5례환자행혈청학검사,우공막배사구취재도편급배양.치료처치위수선정용전필서안약수,연후급여촉진조직수복적패복서혹중조인표피생장인자안액점안,대유혈관장입공막융해구시정용;기중2례공막심층융해범위교대행대체결막판전위수복.결과 5례환자취재배양균미견미생물생장.기중3례약물치료2～3주우공막융해처가견혈관급섬유조직생장,병축점유구결막상피조직복개;2례대체결막판전위수복유합량호.결론 수술인소、자체면역반응혹초민반응、안표조직수복장애,시도치익상노육절제술후공막융해적주요원인.감소수술창상여합리용약,가유효치료화예방공막융해병발증적발생.
Objective To analyze the causes and treatment of complications of scleral melting after pterygium excision.Methods Retrospective analysis of the clinical manifestations of 5 patients appeared scleral melting complications after received pterygium excision combined with autologous limbal stem cell transplantation in the Department of Ophthalmology of Dali People's Hospital from August 2008 to May 2013.The 5 patients underwent serological examination,and scleral necrosis area were smeared and cultured.Treatment:first stopped using TobraDex eye drops,and then gave recombinant bovine basic fibroblast growth factor eye drops or recombinant human epidermal growth factor eye drops to promote tissue repair and stopped using it when vessels entered the scleral melting zone.However,2 cases with deep scleral melting range underwent pedicle conjunctival flap repair.Results There were no microbial growth in the culture.Among the 3 cases of drug treatment for 2-3 weeks,visible blood vessels and fibrous tissue growth in scleral melting area,and gradually conjunctival epithelium covering; the other 2 cases of pedicle conjunctival flap for the repair showed good healing.Conclusions The operation factors,autoimmune reaction or hypersensitivity,ocular surface tissue repair,is the main cause of scleral melting after pterygium excision.Reduce operation trauma and rational drug use,can produce effective treatment and prevention of complications of scleral melting.
