(精选)眼部手术教学课件.pptVIP

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. 【surgical method】 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. The triangles have been removed and all incisions completed. 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 sutures in place 2 mm apart. If the conjunctiva is mobile it is sutured to the skin edge,filling the defect with a simple continuous suture. This helps prevent retraction of the advancement flap. 【术后护理】 全身应用抗生素 局部温敷，以减轻肿胀和疼痛 术后可能发生渗血，从创口或鼻腔流出血色液体，一般3~4d后可逐渐减少 术后7~10d拆线 五、眼球摘出术 【适应症】严重眼穿孔、眼突出，眼内肿瘤，难以治愈的青光眼，眼内炎，全眼球炎等。 【保定】 多数采取侧卧保定 【术式】 主要有两种。一是经结膜眼球摘除术；二是经眼睑眼球摘除术，尤其适用于全眼球化脓和眶内肿瘤蔓延到眼睑时。 【麻醉】大动物可采用全身麻醉或球后麻醉或眼底封闭，小动物通常采用全身