义眼台植入术后脓性肉芽肿形成原因的探讨

目的探讨珊瑚多孔羟基磷灰石义眼台植入术后脓性肉芽肿形成的原因。方法回顾性分析我院羟基磷灰石义眼台植入250例,及外院手术者1例,共251例(251眼),对其中发生脓性肉芽肿的病例、分析其发生的原因。随诊4月~9年。结果251例中发生脓性肉芽肿4例(包括外院1例),其中1例脓性肉芽肿形成时,义眼台尚未钻孔,3例在钻孔及栓钉置入术4~7年后脓性肉芽肿形成。4例保守治疗效果欠佳,3例最终行义眼台取出术,1例拒绝手术。结论脓性肉芽肿形成是羟基磷灰石义眼台眶内植入较少见的并发症,发生原因与义眼台暴露,义眼台血管纤维化不足,义眼台钻孔及栓钉置入等有关。脓性肉芽肿的形成预示义眼台发生了感染,致病菌以厌氧性革兰氏染色阳性球菌为主。义眼台取出术是治疗的关键。

Causes of pyogenic granuloma after hydroxyapatite orbital implantation

Objective To analyse the causes of pyogenic granuloma after hydroxyapatite orbital implant ation.Methods 250 cases(250 eyes) of hydroxyapatite orbital implantation in our hospital and 1 case(1 eye) in other hospital were reviewed retrospectively,all patients were followed up from 4 months to 9 years.Results 4 of 251 cases of hydroxyapatite orbital implantation developed pyogenic granuloma(1.2%).Pyogenic granuloma occurred in 1 unpegged implant patient and 3 patients after pegging and drilling of hydroxyapatite orbital implanta over 4-7 years.The pyogenic granuloma could not controlled by medical therapy effectively.Implants were removed in 3 of 4 cases and 1 case refused to remove the implant.Conclusion Pyogenic granuloma was serious complications that can occur after the hydroxyapatite implantation.Implant exposure,partial vascularization,pegging and drillng of HA implanta are the factors that affect development of pyogenic granuloma.And the implants should be removed.