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目的 :观察自体阔筋膜遮盖暴露义眼座的临床效果。方法 :13例、13眼根据原眼球摘除术的术式用 3种方法修补 :(1)眼内容物剜除术后义眼座暴露者 ,钝性分离已裂开的球结膜及Tenon’s囊 ,暴露巩膜及义眼座 ,将阔筋膜置于暴露义眼座及巩膜表面 ,于阔筋膜边缘与相应处巩膜间断缝合 ,将球筋膜覆于阔筋膜上间断缝合 ,连续缝合球结膜 ;(2 )眼球摘除术后眼座暴露在修补术中未找到 4条眼外直肌者 ,分离球结膜、Tenon’s囊及义眼座 ,将阔筋膜置于义眼座暴露处与Tenon’s囊之间 ,将阔筋膜边缘与后部球筋膜间断缝合 ,将前部球筋膜覆于阔筋膜上间断缝合 ,连续缝合球结膜 ;(3)眼球摘除术后义眼座暴露 ,在修补术中找到4条眼外直肌者 ,将阔筋膜置于义眼座暴露处 ,4条直肌按原生理功能缝于阔筋膜相应处 ,分别缝合球筋膜和球结膜。结果 :13例术后反应轻 ,无结膜裂开及坏死 ,无义眼座裸露 ,脱位、感染等发生 ,眼窝成形好。结论 :阔筋膜作为修补暴露义眼座的一种材料 ,取材方便 ,来源丰富 ,无免疫反应 ,效果满意 ,值得推广。
Objective: To observe the clinical effect of self-fascia labyrinth cover exposed prostheses. Methods: Thirteen eyes were repaired by three methods according to the original enucleation procedure: (1) the ocular surface was excised and the blunt conjunctiva and Tenon’s sac were dissected. Exposure of the sclera and eyelid seat, the fascia lata placed on the exposed eye and sclera surface, at the edge of the laminectomy and the corresponding scleral intermittent sutures, the fascial fascia lacrimal fascia laced suture, continuous suture conjunctiva; (2) Exophthalmos after enucleation Except no 4 extraocular rectus muscles were found in the repair, the conjunctiva, Tenon’s sac and oculomotor septum were separated, and the fascia lata was placed in the eye socket with Tenon’s sac Between the fascia labrum edge and the posterior fascia intermittent sutures, the anterior fascia laced on the fascia labyrinth interrupted sutures, continuous suture conjunctiva; (3) enucleation of the eye after enucleation, during repair Find 4 extraocular rectus, the fascia lata placed in the exposed position of the eye, 4 rectus muscle according to the original physiological function stitched in the corresponding laparoscopic fascia and suture, respectively, ball and conjunctiva. Results: Thirteen patients had mild or no postoperative conjunctival rupture and necrosis, and had no orbital nudity, dislocation and infection. Conclusion: Fascia fascia is a kind of material for repairing the prosthesis. It is easy to draw, abundant in origin, immune response and satisfactory in effect. It is worth popularizing.