游离组织片移植治疗热灼伤致瘢痕性睑内翻

Application of free tissue grafts in cicatricial entropion after thermal burn

目的探讨游离组织片移植在热灼伤后瘢痕性睑内翻中的应用价值,寻求更稳定有效的治疗手段。方法自2002年1月至2007年12月,热灼伤所致瘢痕性睑内翻21例（23眼）,采用自体睑板-结膜瓣游离移植14例（15眼）,采用保存异体巩膜组织片游离移植7例（8眼）。结果随访6-36个月,平均18.7月。采用自体睑板-结膜瓣移植显效14眼,好转1眼;采用保存异体巩膜组织片移植好转5眼,无效3眼。结论自体睑板-结膜瓣游离移植组织相容性好,无融解吸收,具有较稳定的手术效果,但因取材局限而限制了矫正范围。保存的异体巩膜组织来源广泛,术后早期效果较好,后期因植片融解吸收而影响疗效。

Objective To discuss the application value of free tissue grafts in cicatricial entropion after thermal burn and look for therapy measures with more stable effect. Methods From Jan 2002 to Dec 2007,23 eyes of 21 cases with cicatricial entropion that caused by thermal burn were treated.Including 15 eyes of 14 cases were grafted with autogenous tarsi-conjunctival flap and 8 eyes of 7 cases were grafted with preserved allogeneic sclera film. Results Following-up 6-36 months with average of 18.7 month shows that grafts with autogenous tarsi-conjunctival flap got effective rate of 100% including 14 eyes markedly efficient and 1 eye improved,while grafts with preserved allogeneic sclera film got effective rate of 62% including 5 eyes improved and 3 eyes of no avail. Conclusions Graft with autogenous tarsi-conjunctival flap has a good histocompatibility without dissolved absorption and a more stable operation effect,but its scope of the correction is limited due to restrictions based on the material getting.Graft with preserved allogeneic sclera film has a wide range of source and better early postoperative results,but its curative effect is weakened by dissolution and absorption of the grafts latterly.