眼部碱性化学伤的早期抢救

Early emergency treatment for alkali chemical burn

探讨碱性化学伤的早期抢救。患者在受伤二周内行板层角膜移植术 ,临床上获得满意效果 ,打破早期行板层角膜移植术的禁区。方法 :2 5例患者 (2 5眼 ) ,轻度 6例 ;中度 1 2例 ;重度 7例 ,全部采用甘油冷冻保存角膜行板层角膜移植术 ,术后随访二年。结果 :角膜植片透明 7例 ;半透明 1 0例 ;混浊 6例 ;排斥反应 2例 ;经用激素治疗后植片转半透明。术后视力 0 .6占 1眼 ;0 .4占 3眼 ;0 .2占 6眼 ;0 .1以下占 9眼 ;指数以下占 6眼。结论 :碱性化学伤只有尽早彻底切除受损的组织 ,才能有效阻断组织坏死 ,从而减少免疫反应的发生 。

Objective: to investigate the early emergency treatment for alkali chemical burn. Satisfactory effect was obtained clinically. Methods: Lamella keratoplasty was run in 25 cases (25 eyes) patients who were burn within 2 weeks, 6 cases were in mild damage, 12 cases in moderate and 7 cases in severe. Lamella keratoplasty. All the donor grafts were glycerin-frozen cornea, and all cases were followed up for 2 years after operation. Results: The corneal graft was transparent in 7 cases, semitransparent in 10 cases, opaque in 6 cases. 2 cases showed the rejection reaction initially, but after applying steroid the grafts turned to semitransparent. Vision after operation were 0.6 in 1 eye, 0.4 in 3 eyes, 0.2 in 6 eyes, 6 eyes less than 0.1, finger counting in 6 eyes. Conclusion: In alkali chemical burn, the damaged tissues have to be cut off as early as possible so that the necrosis of tissues could be administrated early, the immunoreactions would be inhibited and the complications would be reduced.