硬腭黏膜移植联合眉上转移皮瓣修复上睑全层缺损

首都医科大学学报 ›› 2005, Vol. 26 ›› Issue (3): 283-285.

硬腭黏膜移植联合眉上转移皮瓣修复上睑全层缺损

李冬梅, 秦毅, 陈涛, 赵颖

首都医科大学附属北京同仁医院北京同仁眼科中心

收稿日期:2005-05-19 修回日期:1900-01-01 出版日期:2005-06-24 发布日期:2005-06-24

Treating Completed Eyelid Defect with Hard-palate and a Pedicled Flap above the Eyebrow

Li Dongmei, Qin Yi, Cheng Tao, Zhao Ying

Beijing Tongren Ophthalmic Center, Beijing Tongren Hospital, Capital University of Medical Sciences

Received:2005-05-19 Revised:1900-01-01 Online:2005-06-24 Published:2005-06-24

摘要/Abstract

摘要： 目的探讨用硬腭黏膜植片替代缺损后层眼睑组织,同时转移眉上皮瓣修复缺损前层眼睑皮肤的临床疗效.方法对18例全层上眼睑缺损的患者,全部用口腔硬腭黏膜移植片替代睑板和结膜,再造后层眼睑;用眉上带蒂皮瓣转移覆盖于硬腭黏膜之上,代替缺损的眼睑皮肤,再造前层眼睑.术毕行睑缘缝合,半年后切开.术后对硬腭植片及其周围组织行病理学检查,观察植片的转归及其周围组织的情况.结果全部病例随访12个月以上,硬腭植片及转移皮瓣全部成活,无移位、感染或坏死等不良反应;眼睑外观及功能改善满意,获得良好疗效.病理检查硬腭黏膜胶原纤维仍然排列整齐,周围组织与其愈合良好.结论眉上转位皮瓣与眼睑皮肤薄厚色泽相近,由于有血液供应,易成活,且操作简单损伤小,易于被接受;硬腭黏膜植片的外形硬度与睑板近似,有良好的支撑作用,有柔软的黏膜表面,术后收缩少,取材方便,成活率高.硬腭黏膜移植联合眉上转移皮瓣修复上睑全层缺损,可以一次性修复缺损的皮肤、睑板、结膜,效果肯定,具有较高的临床价值.

关键词: 硬腭黏膜, 眼睑, 重建, 带蒂皮瓣

Abstract: Objective The study focus on the utilization of hard-palate and a pedicled flap above the eyebrow for treating completed eyelid defect. Methods The objects were eighteen patients with 18 sick eyes. After the different layers of eyelid were completed separated, hard-palate and the pedicled flap were harvested. Both of them were used to reconstruct the eyelid. Results Following up over 18 months, none of the 18 eyes were failed. Histologic observation of grafted hard-palate mucous revealed 6 to 7 layers of squamosal epithelium which also had similar tightened subepithelial collagen fibrils of tarsal plate. Conclusion The combines transplantation of hard-palate and this flap can supply a reconstruction of palpebral skin and tarsal plate on patients with completed eyelid defect by only one step.

Key words: hard-pabte, eyelid defect, reconstruction, pedicled flap

中图分类号:

R779.64

李冬梅;秦毅;陈涛;赵颖. 硬腭黏膜移植联合眉上转移皮瓣修复上睑全层缺损[J]. 首都医科大学学报, 2005, 26(3): 283-285.

Li Dongmei;Qin Yi;Cheng Tao;Zhao Ying. Treating Completed Eyelid Defect with Hard-palate and a Pedicled Flap above the Eyebrow[J]. Journal of Capital Medical University, 2005, 26(3): 283-285.

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