“rectus-end-to-end Suture”方法在眼球摘除眼座植入术式中的效果评价

发布时间：2018-08-01 12:02

【摘要】：目的探讨"rectus-end-to-end suture"方法在眼球摘除后Ⅰ期眶内羟基磷灰石眼座植入术中的应用,评估其修复眼窝凹陷的临床效果。方法回顾性分析采用"rectus-end-to-end suture"方法固定羟基磷灰石眼座的患者45例(45眼)。眼球摘除术后,肌椎内Ⅰ期植入羟基磷灰石(Hydroxyapatite, HA)眼座,将内直肌与外直肌、上直肌与下直肌在眼座前表面端对端缝合固定,分层缝合Tenon's囊和结膜囊。术后随访患者主观症状、结膜囊情况、眼座活动度、眼睑的对称性及主观满意度。结果术后随访6-51个月,平均28.3个月。45例患者中,10(22.2%)例患者分泌物增多,2(4.5%)例感眼座不适,3(6.7%)例结膜变薄,1(2.2%)例线结暴露,1(2.2%)例内眦部结膜色素沉着,无一例患者出现眼座暴露、感染等并发症。眼座垂直方向活动度为7.3mm,水平方向活动度为8.8mm。双眼平均睑裂高度和眼球突出度差值分别为1.8mm和1.4mm。患者外观主观满意度调查51%好,40%中,9%差。结论 "rectus-end-to-end suture"方法相比以往的各种眼座植入方法操作简单,在不影响活动度的前提下,降低了眼座植入术后并发症,取得了良好的功能和美观效果,是一种值得推广的方法。
[Abstract]:Objective to investigate the application of "rectus-end-to-end suture" method in orbital hydroxyapatite implantation after enucleation, and to evaluate its clinical effect. Methods 45 cases (45 eyes) of hydroxyapatite eye block fixed with rectus-end-to-end suture method were retrospectively analyzed. After enucleation, hydroxyapatite (Hydroxyapatite, HA) (hydroxyapatite) was implanted into the muscle vertebrae. The medial rectus muscle and the external rectus muscle, the superior rectus muscle and the inferior rectus muscle were sutured and fixed at the end to end of the anterior surface of the ocular seat, and the Tenon's sac and the conjunctival sac were sutured in layers. The patients were followed up with subjective symptoms, conjunctival sac, ocular seat activity, symmetry of eyelid and subjective satisfaction. Results the postoperative follow-up was 6-51 months (mean 28.3 months) .45 cases (22. 2%) had increased secretion 2 (4. 5%), 3 (6. 7%) with conjunctival thinning (2. 2%) and 1 (2. 2%) with inner canthus conjunctival pigmentation. Infection and other complications The vertical and horizontal motion of the eye seat were 7.3 mm and 8.8 mm, respectively. The mean height of eyelid fissure and the difference of exophthalmos were 1.8mm and 1.4mm. The subjective satisfaction of the patients was 51% and 40%, 9% of them were poor. Conclusion "rectus-end-to-end suture" method is easier to operate than all kinds of eye seat implantation methods in the past. It can reduce postoperative complications and achieve good function and aesthetic effect without affecting the range of eye seat implantation. It is a method worth popularizing.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.64

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