眼部烧伤眼睑全层缺损修复术成功的影响因素

目的探讨影响游离皮瓣联合异体巩膜、羊膜移植修复眼睑缺损成功的因素。方法选择2000年2月-2007年10月西安市眼科医院收治的41例（41眼）的眼烧伤眼睑全层缺损者。其中热烧伤15例，碱烧伤20例，酸烧伤6例。烧伤后3～24个月，行大腿内侧游离皮瓣联合同种异体巩膜及羊膜移植术。其中5例联合行睑球粘连分离及板层角膜移植术。术后随访6—36个月。结果眼睑再造术41例中有35例眼睑重建成功，移植片成活，其中5例在6～12个月出现瘢痕收缩，使眼睑部分闭合不全。6例术后2周出现皮瓣愈合不良、脱落、溶解。结论自体游离皮瓣联合同种异体巩膜、羊膜移植修复眼烧伤所致的眼睑全层缺损，是临床治疗烧伤眼睑缺损的有效方法。手术时机的选择、烧伤程度的评估、手术方法的改善是决定手术成功的重要因素。

The clinical observation on transplantation of thigh's inside free skin flap associating with isotype xenoma sclera and amniotic membrane in repairing full eyelid defect caused by burn

Objective To observe the effect of the transplantation of the thigh＇ s inside free skin flap associating with isotype xenoma sclera and amniotic membrane in repairing the full layer eyelid defect caused by burn. Methods Select 41 cases of full layer eyelid defect caused by burn, including 10 cases （ 10 eyelids） of thermal burn, 19 cases （19 eyelids） of alkali burn, 12 cases （12 eyelids） of acid burn. The transplantation of the thigh＇s inside free skin flap associating with isotype xanoma sclera and amniotic membrane was performed in all the cases. All of the cases were followed up for 6 to 36 months after operation. Results 35 cases （35 eyelids） reconstructed eyelids survived. Among of them, scar formation happened in 4 cases （4 eyelids）during the period of 6- 12 months after operation and led to partly hypophasis. Bad healing, abscission of the free skin flap, transplant dissolution and distopy happened in the other 5 cases （5 eyelids） after two weeks of operation. Conclusion The transplantation of autologous free skin flap associating isotypexanoma sclera and amniotic membrane has many virtues. First, the material is convenient to get. The second, the operation progress is simple, and the last is that it ean repair full layer eyelid defect of large area. So it is one of the ideal ways for clinical therapy.