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目的:分析羟基磷灰石(hydroxyapatite,HA)义眼台眶内植入术后结膜脓性肉芽肿形成的原因。方法:回顾性分析我院眶内植入HA义眼台250例(钻孔及栓钉置入68例),随诊18mo~10a,脓性肉芽肿形成后首先药物保守治疗,无效后采用手术治疗。结果:植入HA义眼台250例中发生脓性肉芽肿10例,其中9例在钻孔及栓钉置入术4~7a后发生,1例发生时羟基磷灰石义眼台未钻孔。9例保守治疗效果均欠佳,行HA义眼台取出术,1例拒绝眼台取出而继续保守治疗。结论:脓性肉芽肿是严重的义眼台植入术后并发症,发生原因可能与义眼台植入后血管化不足,义眼台暴露与继发感染,异体材料包被,义眼台钻孔及栓钉置入等因素有关,而与栓钉的材料无关。脓性肉芽肿的发生意味着义眼台可能发生了感染,最终需行义眼台取出术。
Objective: To analyze the causes of formation of conjunctival granuloma after hydroxyapatite (HA) artificial orbital implantation. Methods: A retrospective analysis of 250 cases of HA implantation orbital implantation in our hospital (68 holes and 68 cases) were followed up for 18 to 10 years. After the formation of purulent granuloma, the first conservative treatment was performed, and the treatment was ineffective. RESULTS: Ten cases of purulent granuloma were found in 250 cases of HA eyelid implantation. Nine of them occurred after drilling and screw placement for 4-7 years. Hydroxyapatite was not drilled in one case. Nine cases of conservative treatment are poor, the line of HA Yi eye surgery, 1 case refused to take the eye and continue conservative treatment. Conclusions: Purulent granuloma is a serious complication after implantation of artificial eye, which may be related to the insufficiency of vascularization after prosthetic implantation, the exposure of prosthetic eye and secondary infection, the coating of allogenic materials, Drilling and bolt placement and other factors, but nothing to do with the stud material. The occurrence of purulent granuloma means that the infection may occur in the eye, which eventually leads to the removal of the eye.