CAJ | 학술논문

目的评价硬腭黏膜重建下睑后层后的转归.方法对2007年至2011年在深圳市眼科医院诊治的13例下睑恶性肿瘤患者行Moth切除、硬腭黏膜移植联合眼周皮瓣转移重建眼睑及睑缘粘连术,6个月后行睑缘粘连分离术,术中切取睑缘部分硬腭黏膜送病理组织学检查,于术后第一天用裂隙灯显微镜检查眼前节,用激光角膜共焦显微镜检查活体硬腭黏膜.结果病例在裂隙灯显微镜下眼睑形态良好,角膜透明.在激光角膜共焦显微镜下位于眼睑中部的硬腭黏膜上皮层的细胞结构清晰,排列规则,细胞边界清晰,几乎没有细胞激活现象及炎性细胞,可见小动脉和小静脉及其内流动的血细胞,上皮嵴结构较清晰,边界尚清楚.光学显微镜下硬腭黏膜上皮角化不明显,上皮与固有膜交界处较平坦,上皮钉突和乳头均不明显,发现杯状样细胞,结构类似结膜上皮.结论硬腭黏膜移植重建下睑后层6个月时与残余眼睑组织相容良好,受眼局部微环境的影响,逐渐向结膜的形态发生了改变.
목적 평개경악점막중건하검후층후적전귀.방법 대2007년지2011년재심수시안과의원진치적13례하검악성종류환자행Moth절제、경악점막이식연합안주피판전이중건안검급검연점련술,6개월후행검연점련분리술,술중절취검연부분경악점막송병리조직학검사,우술후제일천용렬극등현미경검사안전절,용격광각막공초현미경검사활체경악점막.결과 병례재렬극등현미경하안검형태량호,각막투명.재격광각막공초현미경하위우안검중부적경악점막상피층적세포결구청석,배렬규칙,세포변계청석,궤호몰유세포격활현상급염성세포,가견소동맥화소정맥급기내류동적혈세포,상피척결구교청석,변계상청초.광학현미경하경악점막상피각화불명현,상피여고유막교계처교평탄,상피정돌화유두균불명현,발현배상양세포,결구유사결막상피.결론 경악점막이식중건하검후층6개월시여잔여안검조직상용량호,수안국부미배경적영향,축점향결막적형태발생료개변.
Objective To assess the outcomes of hard palate mucosa after autogenous hard palate mucosa grafting for posterior lamellar eyelid reconstruction.Methods Thirteen patients with malignant tumor on the lower eyelids were treated at Shenzhen Eye Hospital between 2007 and 2011.All patients underwent reconstruction of the lower eyelids using hard palate mucosal grafts combination with orbicularis musculocutaneous flap and ankyloblepharon following Moth tumor excision,and division ankyloblepharon 6 months later.During division ankyloblepharon,a small piece of hard palate mucosal was resected from palpebral margin and examined by pathology.The ocular anterior segment was examined by slit lamp microscope,and the hard palate mucosal on the lower eyelids was examined by laser corneal confocal microscopy the next day.Results A satisfactory lid shape and position and transparent cornea were achieved in all patients.A clear cells structure and arrangement of stratum epithelium,few activated cells and inflammatory cells,arterioles and venulae,a clear epithelial ridge were visible in the central hard palate mucosal under laser corneal confocal microscopy.Little keratinized stratum epithelium,flat juncture between stratum epithelium and lamina propria,goblet-like cells were visible in the hard palate mucosal under light microscopy.Conclusions Good biocompatibility is visible between hard palate mucosa and remaining eyelids 6 months after autogenous hard palate mucosa grafting for posterior lamellar eyelid reconstruction.Transplanted palate mucosa gradually change towards the structure of conjunctiva epithelium under the influence of ocular microenviroment.