中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2012年
11期
1304-1307
,共4页
羊膜移植%唇黏膜移植%睑球粘连%结膜重建
羊膜移植%脣黏膜移植%瞼毬粘連%結膜重建
양막이식%진점막이식%검구점련%결막중건
Amniotic membrane%Oral mucosal membrane%Ocular burns%Symblepharon%Conjunctival surface reconstruction
目的 比较羊膜与唇黏膜移植重建烧伤眼睑球粘连分离后结膜眼表的手术效果.方法 对98例102只眼因酸、碱和热烧伤引起的睑球粘连进行粘连分离,再联合羊膜(52例53只眼73次手术)或唇粘膜移植(46例49只眼61次手术).结果 术后随访0.5～18年,平均(15.2±21.0)个月.在重度粘连的病例中,两种手术效果差异有显著意义(x2=8.240,P=0.016),行唇黏膜移植手术效果较好.眼烧伤后第一次手术的病例中,如行羊膜移植,则中度睑球粘连患眼在不同时间段的手术效果有显著差异(x2=18.980,P=0.001),12个月后手术效果最好;而唇黏膜移植的手术效果和手术时间关系不明显.距原发烧伤时间6～12个月内,两种手术效果差异有显著意义(x2=6.949,P=0.031),行唇黏膜移植手术效果较好.其他情况下两种手术之间的疗效比较差别均没有统计学意义.结论 唇黏膜移植可以获得和羊膜移植与对重建睑球粘连分离后的结膜眼表一样的疗效.但羊膜移植的手术效果与手术时机的选择有关,而唇黏膜移植则关联不明显.对于重度粘连患者和距离原发烧伤时间较短或太长的患者,唇黏膜移植效果可能更好.
目的 比較羊膜與脣黏膜移植重建燒傷眼瞼毬粘連分離後結膜眼錶的手術效果.方法 對98例102隻眼因痠、堿和熱燒傷引起的瞼毬粘連進行粘連分離,再聯閤羊膜(52例53隻眼73次手術)或脣粘膜移植(46例49隻眼61次手術).結果 術後隨訪0.5～18年,平均(15.2±21.0)箇月.在重度粘連的病例中,兩種手術效果差異有顯著意義(x2=8.240,P=0.016),行脣黏膜移植手術效果較好.眼燒傷後第一次手術的病例中,如行羊膜移植,則中度瞼毬粘連患眼在不同時間段的手術效果有顯著差異(x2=18.980,P=0.001),12箇月後手術效果最好;而脣黏膜移植的手術效果和手術時間關繫不明顯.距原髮燒傷時間6～12箇月內,兩種手術效果差異有顯著意義(x2=6.949,P=0.031),行脣黏膜移植手術效果較好.其他情況下兩種手術之間的療效比較差彆均沒有統計學意義.結論 脣黏膜移植可以穫得和羊膜移植與對重建瞼毬粘連分離後的結膜眼錶一樣的療效.但羊膜移植的手術效果與手術時機的選擇有關,而脣黏膜移植則關聯不明顯.對于重度粘連患者和距離原髮燒傷時間較短或太長的患者,脣黏膜移植效果可能更好.
목적 비교양막여진점막이식중건소상안검구점련분리후결막안표적수술효과.방법 대98례102지안인산、감화열소상인기적검구점련진행점련분리,재연합양막(52례53지안73차수술)혹진점막이식(46례49지안61차수술).결과 술후수방0.5～18년,평균(15.2±21.0)개월.재중도점련적병례중,량충수술효과차이유현저의의(x2=8.240,P=0.016),행진점막이식수술효과교호.안소상후제일차수술적병례중,여행양막이식,칙중도검구점련환안재불동시간단적수술효과유현저차이(x2=18.980,P=0.001),12개월후수술효과최호;이진점막이식적수술효과화수술시간관계불명현.거원발소상시간6～12개월내,량충수술효과차이유현저의의(x2=6.949,P=0.031),행진점막이식수술효과교호.기타정황하량충수술지간적료효비교차별균몰유통계학의의.결론 진점막이식가이획득화양막이식여대중건검구점련분리후적결막안표일양적료효.단양막이식적수술효과여수술시궤적선택유관,이진점막이식칙관련불명현.대우중도점련환자화거리원발소상시간교단혹태장적환자,진점막이식효과가능경호.
Objective To compare the results of amniotic membrane transplantation(AMT)and oral mucosa membrane transplantation(MT)for conjunctival surface reconstruction.Methods One hundred and two eyes of 98 cases who received symblepharon lysis combined AMT or MT for conjunctival surface reconstruction due to symblepharon after eye bums were retrospectively examined,and their history and eye conditions were recorded.Results The follow-up time was 0.5 to 18 years(mean 15.2±21.0 months).There were significant difference statistically between the effects of these two surgeries for conjunctival surface reconstruction in those patients with severe symblepharon(x2=8.240,P=0.016),MT was better.In the cases who received their first AMT,the surgical effects for patients with moderate symblepharon depended on the intervals from burns to surgery(x2=18.980,P=0.001).It was the best for over 12 months after bums.Meanwhile,in the cases who received MT,there was no close relationship between surgical effect and the interval time.The effect of conjunctival reconstruction with MT was better than that with AMT when surgeries were performed in 6-12 months after eye burns(x2=6.949,P=0.031).Conclusions Oral mucosal membrane has at least the same effect of anmiotic membrane for conjunctival surface reconstruction after symblepharon lysis.The effect of AMT depends on the interval time from eye bums to surgery,but MT does not.Oral mucosal membrane transplantation may be better than amniotic membrane transplantation for those patients with severe symblepharon.
