锁边式缝合结膜遮盖治疗真菌性角膜溃疡疗效分析

Analysis the effective of continuous side whipstitch suture in conjunctival cover

目的 评价锁边式缝合在结膜遮盖术中的疗效.方法 临床病例对照研究.回顾总结对2010年5月至2013年3月在沧州眼科医院诊治真菌性角膜溃疡需行结膜遮盖术患者,能够坚持随访3个月的资料完整病例共56例（56只眼）,根据结膜瓣缝合方式不同分成两组：其中观察组患者29例29只眼,采用锁边式缝合结膜瓣;对照组患者27例27只眼,采用间断或连续缝合结膜瓣.观察患者主观症状,结膜瓣及角膜溃疡愈合情况.结果 术后1周,主观症状方面观察组较对照组轻微,差异有统计学意义（P＜0.05）;结膜瓣愈合方面,观察组较对照组结膜瓣早期愈合好,差异有统计学意义（P＜0.05）;术后1周,溃疡复发眼数比,观察组1/29只眼（3.45％）明显低于对照组为2/27只眼（7.41％）,差异有统计学意义（P＜0.05）;术后3个月两组病例结膜瓣愈合良好,无脱落、无溃疡复发.结论 连续锁边缝合是一种良好地缝合技术,术后眼表刺激症状轻微,结膜瓣存活率高,溃疡复发率低,提高了手术疗效.

Objective To evaluate the curative effect of continuous side whipstitch suture in the surgery of conjunctival cover.Method A case control study.The 56 cases with completed data of fungal corneal ulcer cases which were hospitalized and accepted the surgery of conjunctival cover from March 2010 to March 2013 were analyzed retrospectively.These cases were divided into two groups.The control group included 27 cases （27 eyes）,which accepted disconnected or connected suture in conjunctival graft.The test group included 29 cases （29 eyes）,accepted continuous side whipstitch suture in surgery.The follow-up time was three months.The condition of conjunctival graft and corneal ulcer including patient subjective symptom were recorded.Results One week after surgery,the subjective symptom and condition of test group was better than that of control group,and there was.The ulcer recurrence in test group was one eye but two eyes in control group,the rate of recurrence was statistical significant difference （P ＜0.05）.Conclusions The continuous side whipstitch suture in conjuctival graft is very well.Using this technique in surgery can improve the survival rate of conjuctival graft and reduce the recurrent rate of corneal ulcer.It should be used in conjtmctival graft intensively.