第七章_眼部手术.pptVIP

第 七 章 眼 部 手 术 主 要 内 容 一、眼睑内翻矫正术 二、眼睑外翻矫正术 三、第三眼睑腺摘除和复位术 四、 Excision of Eyelid Tumors 五、眼球摘出术 六、眼睑损伤的修复 【术后护理】 患眼涂布或滴入抗生素眼膏或抗生素眼药水，3~4次/d。 颈部安装颈圈，防止自我损伤病眼。 术后10~14d拆线。 术后数日局部肿胀可逐渐减轻 【术后护理】 患眼涂布或滴入抗生素眼膏或抗生素眼药水，3~4次/d。 颈部安装颈圈，防止自我损伤病眼 术后10~14d拆线。 术后数日内局部肿胀可逐渐减轻 【保定和麻醉】侧卧或胸侧卧保定。全身麻醉，先以速眠新复合麻醉剂做浅麻醉，再以加有青霉素液的注射用水(每l0ml加青霉素10万IU)冲洗眼结膜，然后滴入加有肾上腺素的局部麻醉剂。 2.轻轻牵引缝合线，显露腺体根蒂部，用止血钳钳夹根蒂细缩部 （图3-6） 3.用手术刀紧贴止血钳切除腺体（图3-7） 4.止血钳暂不松开，用烧烙法止血，其方法为：将注射针头在酒精灯上烧红后，立即用针头烧烙而使出血点止血。松开止血钳（图3-8），用3%氯霉素眼药水点入患眼结膜囊内，松解保定。 四、Excision of Eyelid Tumors Eyelid tumors are common in the dog. The tarsal gland adenoma is the most frequently diagnosed eyelid tumor in the dog. Less commonly found are adenocarcinomas,melanomas and papillomas. The tarsal gland adenoma, as with most tumors of the canine eyelid,is clinically benign,and surgical excision is usually curative. Cryosurgery using 1iquid nitrogen at -20℃ can also be used to treat these tumors. As the conjunctiva is not involved, it is not removed. Incisions are outlined by dotted lines. The incisions are marked on the patient with a plastic surgery marking pen. The vertical sides of the triangles are 20 per cent longer than the vertical incisions adjacent to the tumor to allow for wound contraction. A square or rectangular incision is made around the tumor. The tumor is dissected off from the base toward the lid margin. The tumor is removed and placed in fixative,and is pinned to a piece of cardboard to allow the ophthalmic pathologist to examine the margins for evidence of tumor. Note：If tumor is present in any margin, excision has been incomplete. The previously marked triangle is elevated and excised. To prevent tension on the wound, the tissues surrounding the triangles and the flap are undermined. The flap is advanced to the margin with no tension on it. Simple marginal sutures of 6-0 silk are placed. Sutures are placed at the corners of the incision to assist in accurate placement of subsequent sutures. Remaining sut