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目的:观察应用带蒂结膜瓣转位遮盖术治疗难治性角膜溃疡的临床疗效。方法:回顾性分析2005年6月至2009年6月在湘雅二医院行带蒂结膜瓣转位遮盖术治疗的56例56眼,其中感染性角膜溃疡36眼,角膜移植术后植片溃疡9眼,外伤致角膜溃疡4眼,化学伤致角膜溃疡7眼,均采用了病灶清除联合带蒂结膜瓣转位遮盖术。结果:47例(83.9%)患者一次手术治愈,5例(8.9%)出现结膜瓣回退,3例行再次手术后治愈,2例患者行3次结膜瓣手术获得治愈,4例(7.2%)由于真菌性角膜溃疡复发改行板层角膜移植术。52眼(92.9%)经采用带蒂结膜瓣转位遮盖术治愈角膜溃疡保全眼球,获得不同程度的视力增加。结论:带蒂结膜瓣转位遮盖术仍是有效的临床治疗手段。
Objective: To observe the clinical effect of pedicle conjunctival flap transposition and masking in the treatment of refractory corneal ulcer. Methods: 56 patients (56 eyes) with pedunculated conjunctival flap transposition and masking surgery in the Second Xiangya Hospital from June 2005 to June 2009 were retrospectively analyzed. Incisional corneal ulcer was observed in 36 eyes. After the corneal transplantation, 9 eyes, 4 eyes with corneal ulcer caused by trauma and 7 eyes with corneal ulcer caused by chemical injury. All of them were treated with focal eyelid conjunctival flap transposition and masking. Results: 47 cases (83.9%) were cured by one operation, 5 cases (8.9%) had conjunctival flap regression, 3 cases were cured by reoperation, 2 cases were cured by conjunctival flap operation 3 times, 4 cases (7.2% ) Due to recurrence of fungal corneal ulceration lamellar keratoplasty. Fifty-two eyes (92.9%) were treated with pedicle conjunctival flap transposition and masking to heal corneal ulcer and preserve the eyeballs with varying degrees of visual acuity. Conclusion: The pedicle conjunctival flap transposition and masking is still an effective clinical treatment.