结膜瓣遮盖联合睑裂缝合术予规范化药物干预治疗难治性角膜溃疡的临床分析陈莺（四川省仁寿县人民医院四川仁寿620500）【摘要】R的：分析结膜瓣遮盖联合睑裂缝合术予规范化药物干预治疗难治性角膜溃疡的临床疗效。方法：将我院收治的54例（54只眼）难治性角膜溃疡患者随机分为观察组27和对照组27例。对照组患者行结膜瓣遮盖联合睑裂缝合术予常规药物干预治疗，观察组患者行结膜瓣遮盖联合睑裂缝合术予规范化药物干预治疗。评价2组患者的临床治疗效果，检测手术前后患者的裸眼视力及泪膜功能，并随访统计患者的复发率。结果：观察组患者临床治疗的总有效率为92.59%,对照组为74.07%，2组比较，差异具有统计学意义（P<0.05）。术后1个月、3个月，2组患者的裸眼视力、BUT及STt较术前均提高，但观察组患者的提高幅度均人于对照组（P均<0.05）。1年的随访期间，观察组患者角膜溃疡的复发率为7.41%,对照组为22.22%，2组比较，差异具有统计学意义（P<0.05）。结论.•在结膜瓣遮盖联合睑裂缝合术治疗难治性角膜溃疡的基础上配合规范化药物干预能有效提高手术治疗效果，促进裸眼视力及泪膜功能的提高，并降低复发率。【关键词】难治性角膜溃疡：结膜瓣遮盖：睑裂缝合术：药物干预【中图分类号】R772.21【文献标识码】B【文章编号】1003-5028（2015）7-0152-02Analysisofconjunctivalflapcoveringjointpalpebralfissuresurgeryandstandardizationofdruginterventioninthetreatmentofrefractorycornealulcer【Abstract】objective:toanalyzeconjunctivalflapcoveringjointpalpebralfissuresurgeryandstandardizationoftheclinicalcurativeeffectofdruginterventionintreatmentofrefractorycornealulcer.Methods:ourhospital’s54cases(54eyes)withrefractorycornealulcerpatientsweredividedintoobservationgroup(27)andthecontrolgroup(27cases).Thecontrolgrouppatientsweretreatedbyjointpalpebralfissuresandconjunctivalflapcoveringsurgeryandconventionaldrugintervention,theobservationgroupofpatientsweretreatedbyconjunctivalflapcoveringjointpalpebralfissuresurgeryandstandardizationofdrugintervention.2groupsofpatientswiththeclinicaltreatmenteffectwereassessed,beforesurgeryandaftersurgery,patientswiththenakedeyeeyesightandappearfunctionwasdetected;therecurrencerateofthepatientswascounted.Results:observationgroupofpatientswithclinicaltreatmentthetotaleffectiveratewas92.59%,controlgroupwas74.07%,thecomparisonoftwogroups,statisticallysignificantdifference(P<0.05).After1month,3months,twogroupofpatientswiththenakedeyeeyesight,BUTandSTtbeforeoperationwereimproved,BUTtheincreaseofobservationgroupofpatientswasgreaterthanthecontrolgroup(P<0.05).1yearfollow-upperiod,theobservationgroupofpatientswithcornealulcerrecurrenceratewas7.41%,controlgroupwas22.22%,thecomparisonoftwogroups,statisticallysignificantdifference(P<0.05).Conclusion:injointpalpebralfissuresandconjunctivalflapcoveringsurgerytreatmentofrefractorycornealulcerwithstandardizationonthebasisofdruginterventioncaneffectivelyimprovetheeffectofsurgicaltreatment,promotethefunctionofvisionanditappearsinuca,andreducetherecurrencerate.【Keywords]intractablecornealulcer;Conjunctivalflapcovering;Palpebralfissuresurgery;Drugintervention角膜溃疡是发生于眼部角膜处的溃疡性炎性病变，为眼科常见病。在解剖学上，因角膜无血管直接供应而代谢缓慢，造成病理代谢产物长期滞留，炎症过程常迁延难愈，从而给该病的治疗造成一定的难度。加之近年来随着广谱抗生素和皮质类固醇药物的广泛泣用，导致角膜溃疡致病菌耐药率日趋上升，进而出现一类以用药无效、病情反复迁延、病程长为显著特征的难治性角膜溃疡，成为威胁人们身心健康和生活质量的重要疾病因素。B前，结膜瓣遮盖是临床上所广泛采用的治疗难治性角膜溃疡的手术方式，且以其操...
