摘要
目的 评价烧伤后用全厚皮片行眼窝再造术联合羟基磷灰石义眼座置入的疗效。方法 对 10例由于铁水、强酸、强碱及火药烧伤引起的眼窝闭锁进行手术治疗。其中已摘除眼球者 6例 ,有残留萎缩眼球者 4例。对 8例眼部烧伤患者行一期羟基磷灰石义眼座置入同时行全厚皮片移植眼窝再造术 ,2例为义眼座置入后二期行眼窝再造术。皮片取自上臂或大腿内侧 ,包裹自制眼模在置入羟基磷灰石义眼座后置入眼窝内 ,上下眼睑行睑缝合术 ,术后 6～ 10个月剪开睑缘 ,定制义眼片。结果 经 8～ 3 6个月 (平均 2 3 .2个月 )的随访 ,皮片均成活 ,义眼座无暴露 ,无继发感染 ,患眼上下穹窿形成好 ,放置义眼片后外观满意 ,无义眼片自行脱出现象。结论 对一些已无结膜组织的严重烧伤患者 ,用全厚皮片行眼窝再造术是较为有效的手术方法。
ObjectiveTo evaluate the clinical effect of conjuncti va l sac reconstruction associated with hydroxyapatite implantation to correct co njunctival sac atresia after burn injury of eye. MethodsA g roup of 10 patients whose eye was burned by melted iron or acid or alkali or pow der were investigated in this study. It was 3 to 32 months after burning(averag e 15.6 months). 6 patients were after enucleation of eyeball and 4 patients had atrophy eyeball. 8 patients with severely contracted sockets after burn injury underwent socket reconstruction using free skin flaps associated with hydroxyapa tite sphere first or second implantation, and 2 patient was operated after hydro xyapatite had been implanted. The implant hydroxyapatite was produced by IOI Com pany, USA and its diameter was 20 mm. The skin flap was adopted from medial side of the arm or thigh. A eye model which was made by ourselves was wrapped by the skin flap, and implant into eyelids after hydroxyapatite had implanted. Supe rior and lower eyelid was fused by suture, and was cut 6～10 months after operat i on. The customized artificial eye was fixed at that time. ResultsAll the skin flaps of these 10 cases survived after following-up for 8 to 36 months (average 23.2 months). There were no secondary infection or implant exposure occurred. The superior and inferior skin sac was deep enough to fix o cular prosthesis. All patients' cosmesis was acceptable. No artificial eye drop ped out itself. ConclusionsConjuctival sac reconstruction using free skin flaps associated with hydroxyapatite sphere implantation is a u seful option in the surgical rehabitation of contracted sockets after severe bur n injury of the eye.
出处
《中华医学美学美容杂志》
2003年第6期334-336,共3页
Chinese Journal of Medical Aesthetics and Cosmetology
