静吸复合麻醉下行婴儿角结膜皮样瘤摘除术

Effects of simple excision of corneal dermoids with isoflurane inhalation in infancy

目的:观察静吸复合麻醉下行婴儿角结膜皮样瘤摘除术的临床效果。方法:18例年龄为1～6(平均3.8)mo的儿童角结膜皮样瘤行皮样瘤单纯切除术,术区用结膜或羊膜覆盖。麻醉采用静吸复合麻醉,术前肌注阿托品0.02mg/kg,诱导麻醉:本组药物均用咪唑安定0.1mg/kg,氯胺酮0.1mg/kg,万可松0.1mg/kg静脉注入快速诱导麻醉;麻醉维持:吸入10～150g/L异氟醚以及异丙酚静脉泵注。结果:18例均位于眼球颞侧角膜缘,无1例伸入角膜中央。麻醉期间患儿呼吸循环各项指标均正常,且无任何并发症发生,术毕迅速苏醒。术后随访6mo～5a,17例治愈,达到无并发症愈合,仅1例复发。结论:6mo以内在静吸复合麻醉下行婴幼儿角结膜皮样瘤摘除术值得提倡。

AIM： To access the surgical outcomes of early excision of corneal dermoids with isoflurane inhalation in infancy. METHODS： Eighteen patients aged from 1 to 6 months with corneal dermoids underwent simple excision. The incision was covered by conjunctiva or amniotic membrane under isoflurane inhalation. Intravenous inhalational anesthesia was adopted. RESULTS. The lesions of all 18 cases were located near the limbus of the cornea in the inferotemporal quadrant, and could only rarely be observed in more central regions of the comea existed. The way of isofluane inhalation was safe to children and supported by operation at early age. With 6 months to 5 years follow-up, 17 cases postoperative results reached to uncomplicated healing with cosmetic improvement, only 1 case recurrent. CONCLUSION： Surgical interventions in children of corneal dermoids with isoflurane inhalation before 6 months are recommended.