结膜新月形切除加巩膜固定术治疗结膜松弛症的临床分析

Clinical Analysis of Conjunctival Crescent Resection Plus Scleral Fixation for Conjunctival Relaxation

目的研究分析在结膜松弛症患者中实施结膜新月形切除加巩膜固定术治疗的临床效果。方法选取在该院接受治疗的结膜松弛症患者作为研究对象,选取时间段为2014年7月—2018年1月,病例数为60例。针对全体患者实施结膜新月形切除加巩膜固定术治疗,分析手术前以及手术后6个月的患者自觉症状评估情况、尝味试验、泪河检查和泪膜破裂时间检查、泪河高度(FL)以及泪液分泌值(ST)情况。结果全体患者的手术均顺利完成,手术当中未出现结膜撕裂、下直肌损伤或者眼球贯通等相关并发症,在手术后的6个月随访期内,患者均没有发生眼球运动障碍、睑球粘连、伤口愈合不良或者感染等并发症,恢复情况良好。手术后患者有35例获得治愈,23例获得改善,2例治疗无效,总疗效率为91.67%。手术后患者中荧光素活体染色异常率、泪河异常率显著低于手术前阶段(χ~2=16.415、80.000,P<0.05),尝味试验阴性率显著高于手术前(χ~2=104.650,P<0.05),手术后患者的FL值(4.07±2.36)mm显著低于手术前(7.19±2.39)mm(t=7.195,P<0.05),术后BUT值(13.91±5.69)s显著高于对照组(7.66±2.75)s(t=7.661,P<0.05),术后ST值(10.15±3.49)s与手术前(9.47±2.34)s,差异无统计学意义(t=1.254,P>0.05)。结论临床上针对结膜松弛症患者实施结膜新月形切除联合结膜巩膜固定术治疗效果良好,具有较高的临床价值。

Objective To study the clinical effects of conjunctival craniectomy and scleral fixation in patients with conjunctival relaxation. Methods Patients with conjunctival relaxation who were treated in our hospital were selected as subjects. The time period was from July 2014 to January 2018, and the number of cases was 60. Conjunctival resection and scleral fixation were performed in all patients, and the patient’s symptoms assessment, taste test, tear test and tear film rupture time, tear river height(FL) were analyzed before and 6 months after surgery and tear secretion value(ST).Results All patients underwent surgery successfully. There were no complications such as conjunctival tear, inferior rectus injury or eyeball penetration during the operation. No eye movement disorder or croquet occurred during the 6-month follow-up period after surgery. Complications such as adhesions, poor wound healing or infection, and recovery were good. After the operation, 35 patients were cured, 23 patients were improved, and 2 patients were ineffective. The total response rate was 91.67%. The abnormal rate of fluorescein in vivo staining and the rate of tears in the patients after surgery were significantly lower than those in the preoperative stage(χ^2=16.415, 80.000, P<0.05). The negative rate of taste test was significantly higher than that before surgery(χ^2=104.650, P<0.05), the FL value(4.07±2.36) mm of the patients after surgery was significantly lower than that before surgery(7.19 ±2.39)mm(t=7.195, P<0.05), and the postoperative BUT value(13.91±5.69) s was significantly higher than the control group(7.66±2.75) s(t=7.661, P<0.05),there was no significant difference between the postoperative ST value(10.15±3.49)s and the preoperative(9.47±2.34) s(t=1.254, P>0.05). Conclusion Clinically, conjunctival crescent resection combined with conjunctival scleral fixation for patients with conjunctival relaxation has a good clinical effect and has high clinical value.