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目的 :探讨外伤性睫状体脱离治疗方法的选择。方法 :3 4例外伤性睫状体脱离分为手术与非手术治疗组 ,用超声生物显微镜 (UBM )观察治疗前后睫状体形态学改变。结果 :3 4例中睫状体分离合并睫状体脱离 2 2例 ,睫状体脱离合并房角后退 8例 ;单纯性平坦部脱离 3例 ,环周脱离 1例。睫状体分离合并脱离中 14例行睫状体缝合术 ,19例保守治疗 ,1例行异物取出术。治疗前分离合并脱离的 2 2例UBM表现为睫状体与巩膜突分离。手术 14例中UBM复查 11例睫状体前外侧角附着巩膜突之后 ,其中 8例睫状体脱离消失 ,2例部分平坦部脱离 ,1例呈环周脱离 ,3例表现同术前。非手术治疗 19例中 ,分离 <2个钟点的 6例治疗后睫状体脱离消失 ,分离处睫状体与巩膜突后组织相连 ;分离 >2个钟点的 2例治疗无效。睫状体脱离合并房角后退 8例治疗后睫状体复位。 3例穿通伤加用抗生素后脱离消失。 1例睫状体附近异物取出后脱离仍然存在。结论 :UBM检查对外伤性睫状体脱离治疗方案的选择具有重要参考价值。
Objective: To explore the treatment of traumatic ciliary body detachment. Methods: Thirty-four cases of traumatic ciliary body detachment were divided into operation and non-operation groups. The morphological changes of ciliary body before and after treatment were observed by using ultrasound biomicroscopy (UBM). Results: The ciliary body separation and ciliary body detachment in 22 cases, the ciliary body detachment combined with corner retrospectoration in 34 cases, the simple flat detachment in 3 cases and the circumferential detachment in 1 case. Ciliary body separation and separation in 14 cases of ciliary suture, 19 cases of conservative treatment, 1 case of foreign body removed. Twenty-two patients with UBM that had been separated and treated before treatment showed ciliary body separation from sclera. Of the 14 cases treated by UBM, 11 cases of ciliary anterior lateral horn attached scleral protrusion were observed. Among them, 8 cases of ciliary body detached and disappeared, 2 cases of partial flat detachment, 1 case of circumferential detachment and 3 cases of preoperative cortical protrusion. In the non-surgical treatment of 19 cases, the ciliary body detached and disappeared in 6 cases after 2 hours of separation, and the ciliary body in the separation was connected with the posterior scleral tissue. Two cases of separation> 2 hours were ineffective. Ciliary body detachment combined angle retrograde retreat after 8 cases of ciliary body reduction. 3 cases of penetrating wounds with antibiotics after the disappearance of disappearance. A case of ciliary body in the vicinity of the removal of foreign bodies still exist. Conclusion: UBM examination of traumatic ciliary body detachment treatment options has important reference value.