上唇黏膜移植治疗结膜囊狭窄的疗效观察

Effect of upper lip mucosa transplantation on conjunctival sac stenosis

目的观察应用上唇黏膜移植治疗结膜囊狭窄的临床应用效果,并探讨其临床意义。方法回顾性分析57例(57只眼)接受上唇黏膜移植的结膜囊狭窄患者的临床资料,其中男性35例,女性22例,年龄21~75岁。轻度狭窄5例,中度19例,重度26例,复发7例。所有患者均采用上唇黏膜移植,结膜囊内薄壳支撑,加压包扎1个月。术后6个月行睑缘融合切开,1周后佩戴义眼片,平均随访6.5个月。结果 57例均移植成功,唇黏膜与球结膜融合,结膜囊形态良好,均可配戴适合的义眼。其中2例发生了睑缘融合缝线脱落,1例发生在术后2个月,给予再次睑缘融合后加压包扎1周,6个月后切开融合处,结膜囊形态良好;另1例发生在术后5个月,因结膜囊形态良好,未予处理,6个月时义眼片佩戴正常,其他病例随访期内未见其它并发症。结论上唇黏膜移植是治疗结膜囊狭窄的理想方法,它具有患者进食早,供区恢复快,患者外观影响小等优点,上唇黏膜可作为结膜囊狭窄治疗取材的首选。

Objective To investigate the clinical effect of upper lip mucosa transplantation on conjunctival sac stenosis and related clinical significance.Methods 57 cases of conjunctival sac stenosis treated with upper lip mucosa transplantation were reviewed retrospectively. Among the 57 patients, 35 were males and 22 were females, the age range was 21 to 75 years. 5 cases had mild stenosis,19 cases had moderate stenosis,26 cases had severe conjunctival sac stenosis,and 7 cases had recurrent conjunctival sac stenosis. All the patients underwent free upper lip mucosa transplantation with conjunctival sac supported by thin shell, and compression bandage for 1 month. Palpebral edge fusion incision was performed at 6 months after the surgery, and artificial eye was worn 1 week later. The mean follow-up time was 6.5 months.Results All 57 cases had successful transplantation, with fusion of labial mucosa and bulbar conjunctiva. The conjunctival sac was in good shape, with the depth of fornix suitable for artificial eyes. The limbi palpebralis fusion suture fell out in 2 cased, with 1 occurred at 2 months after the surgery. After refusion surgery and compression bandaged for 1 week, the conjunctival sac was in good shape 6 months later after incision. The other case occurred at 5 months after the surgery, and was left untreated due to good conjunctival sac shape, the prosthesis status was normal at 6 months. No complications were observed during the follow-up of other cases.Conclusions Upper lip mucosa transplantation is an ideal treatment for conjunctival sac stenosis. It has the advantages of early feeding, rapid recovery of supply area, and little influence on patients’ appearance. The upper lip mucosa can be used as the first choice for the treatment of conjunctival sac stenosis.