改良超声生物显微镜检查法在眼表热化学烧伤后中度及重度睑球粘连诊疗中的应用

发布时间：2018-01-28 00:24

本文关键词： 眼表热化学烧伤睑球粘连超声生物显微镜眼前段损伤　出处：《上海交通大学学报(医学版)》2017年11期 　论文类型：期刊论文

【摘要】：目的·评价改良超声生物显微镜(UBM)检查法在眼表热化学烧伤后中度及重度睑球粘连的患者临床诊疗中的应用价值。方法·回顾性收集眼表热化学烧伤导致的中度及重度睑球粘连患者的临床资料,共33例(33眼)。通过改进UBM检查方法,将其应用于患者眼前段检查,分析患者眼角膜、前房、虹膜、房角、睫状体以及晶状体的损伤情况,对比中度与重度睑球粘连合并眼前段损伤的严重程度。结果·33只眼均完成UBM检查。其中角膜基质混浊深度1/2的有29眼,角膜后弹力层脱离有1眼,角膜层间积液有4眼,角膜基质床变薄有2眼,虹膜前粘连有6眼,虹膜后粘连有2眼,前房变浅有2眼,前房高反射渗出有1眼,房角狭窄有6眼,晶状体回声增高有6眼;重度睑球粘连合并的眼前段损伤明显比中度睑球粘连合并的眼前段损伤更严重。结论·UBM作为一种无创性诊断技术,在改进检查方法后可对中度及重度睑球粘连的眼前段组织进行细致观察,显示出常规检查方法不能揭示的病变,为疾病的严重程度、手术方案及预后的判断提供指导。
[Abstract]:Objective: to evaluate the modified ultrasound biomicroscopy (UBM). The clinical value of examination method in the diagnosis and treatment of moderate and severe symblepharon after chemical burn of ocular surface. Methods: the clinical data of patients with moderate and severe symblepharon caused by chemical burn of ocular surface heat were collected retrospectively. A total of 33 cases (33 eyes) were treated with UBM. The corneal, anterior chamber, iris, angle, ciliary body and lens injury were analyzed. Results: UBM was performed in 33 eyes. Among them, 29 eyes had corneal stromal opacity depth of 1/2. There were 1 eye with posterior elastic layer detachment, 4 eyes with corneal interlaminar effusion, 2 eyes with corneal stromal bed thinning, 6 eyes with anterior iris adhesion, 2 eyes with posterior iris adhesion, 2 eyes with shallow anterior chamber, and 1 eye with hyper reflex exudation of anterior chamber. Atrial angle stenosis occurred in 6 eyes and lens echo increased in 6 eyes. The anterior segment injury with severe symblepharon was more serious than that with moderate blepharoconglutination. Conclusion UBM is a noninvasive diagnostic technique. After the improvement of the examination method, we can carefully observe the anterior segment tissue of the moderate and severe blepharoconglutination, and show that the lesions which can not be revealed by the conventional examination method are the severity of the disease. The operative plan and prognosis are provided with guidance.
【作者单位】：上海交通大学医学院附属第九人民医院眼科;
【基金】：国家自然科学基金(81570812,81370992) 上海市教育委员会高峰高原学科建设计划(20161421)~~
【分类号】：R779.6
【正文快照】： 睑球粘连是睑结膜与球结膜发生粘连的疾病。由于眼表等眼表组织变性。常规的眼科检查如裂隙灯检查受到限制,直接暴露在外界,很容易被各种疾病和伤害损伤,例如史影响眼科医生检查患眼角膜、前房、虹膜及晶状体等眼前段约综合征(Stevens-Johnson syndrome)、眼部天疱疮、角结

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