化学烧伤患者眼睑全层缺损的早期修复

Early repair of full layer eyelid defect caused by chemical burn

目的 探讨化学烧伤导致患者眼睑全层缺损后早期修复的时机和方法。 方法 化学烧伤致眼睑全层缺损患者 18例 (19只眼 )。 4周内进行游离鼻中膈黏膜软骨瓣 +肌皮瓣植皮或皮瓣转移修复 ,其中 4例眼睑再造与角膜移植同时完成。 结果 再造眼睑及移植角膜全部成活 ,减少了暴露性角膜炎、角膜溃疡、眼球穿孔等严重并发症的发生。 结论 化学烧伤致全层眼睑缺损应早期修复 ,包括为保护视力、减轻炎症进行的眼睑及时再造 ,和角膜有穿孔危险情况下与角膜移植同期进行的眼睑再造 ;鼻中膈黏膜软骨是再造眼睑较为理想的材料。

Objective To investigate the optimal time and method of the early repair of the full layer eyelid defect caused by chemical burn. Methods Free nasal septum mucosal cartilage flap with muscle flap, skin grafting, or skin flap were performed in 18 cases(19 eyelids) with chemical burn within 4 postburn weeks . Eyelid reconstruction and corneal transplantation were performed at the same time in 4 patients. Results All the reconstructed eyelids and transplanted cornea survived. The incidence of severe complications, such as exposure keratitis, corneal ulcer and eyeball perforation decreased. Conclusion Full layer eyelid defect caused by chemical burn should receive early reconstruction and repair, including timely reconstruction of eyelid for the sake of protecting the eyesight and of alleviating the inflammatory reactions, and the corneal transplantation should be done at the same time to avoid corneal perforation. Nasal septum mucosal cartilage flap could be ideal for the eyelid reconstruction. [