眼部高温金属溶液热烧伤早期干预治疗的临床观察

Observation on early synthetic methods for treatment of ocular thermal burns by hot metal liquid

目的:探讨高温液态金属所致眼烧伤早期的综合治疗方法。方法:患者52例56眼高温铝水或铁水烧伤患者立即予剔除眼部残存的金属异物,抽自血作球结膜下注射,取合适大小的明胶海绵涂上洛美沙星眼凝胶、贝复舒眼凝胶和阿托品眼膏覆盖于角膜表面及结膜囊中包眼。每3d更换一次。同时全身静脉滴注血塞通注射液、抗生素、糖皮质激素,伤后6d停用激素。对于重度眼球热烧伤患者,经上述综合治疗,眼球仍有穿孔危险者,则行羊膜覆盖术。结果:患者56眼均保存了眼球。角膜云翳17眼,角膜斑翳9眼,角膜白斑7眼,假性胬肉18眼,睑内翻11眼,睑外翻1眼,睑球粘连2眼。结论:对高温金属溶液眼部烧伤的早期干预综合治疗,有利于改善患者伤眼的基础条件,预防或减少并发症发生,对二期手术创造较好条件有积极意义。

AIM：To observe early synthetic methods for treatment of ocular thermal burns by hot metal liquid.METHODS：Fifty-six eyes （52 cases） received removement of metal remnant and conjunctival injection of idios blood serum at once.The gelatin sponge absorbed with recombinant bovine basic fibroblast growth factor eye-gel,lomefloxacin eye-gel,and atropine eye onintment,were put into the conjunctival sac and corneal surface.The gelatin sponge were changed every 3 days.The intravenous antibiotic,glucocorticoid and xuesaitong were used to control infection and inflammation and to promote nutrition.On 6th day after injury we stopped using glucocorticoid.Amniotic membrane transplantation was used for the case with the risk of corneal perforation.RESULTS：The eyeballs were all saved in 56 eyes,and nebula in 17 eyes,macula in 9 eyes,leucoma in 7 eyes,pseudo-pterygium in 18 eyes,entropion in 11 eyes,ectropion in 1 eye,symblepharon in 2 eyes.CONCLUSION：Early synthetic therapy for ocular thermal burns by hot metal liquid can promote eye conditions,prevent or reduce complications,and create a good condition for surgery.