兔角膜撕裂伤伤口无创黏合和传统缝合的对比研究

Comparative study on woundless tissue adhesive and suturing for corneal chapped penetrating wound in rabbit

目的探讨a-氰基丙烯酸正辛酯为主体的医用化学组织黏合剂治疗兔眼角膜全层裂伤的可行性。方法35只成年兔平均随机分为3d组、7d组、14d组、30d组、90d组,建立经角膜的穿通伤模型,右眼用医用胶黏合,左眼缝线缝合,观察术后医用胶的降解,对比研究角膜伤口大体和组织病理学愈合情况。结果术中医用胶迅速密闭角膜伤口。术后3d,2组均可见部分兔眼角膜混浊。术后7d,2组兔眼角膜均出现新生血管,医用胶组较缝线组严重,术后30d缝线组大部分消退,医用胶组角膜均残留2～3支新生血管。术后90d2组新生血管基本吸收,医用胶脱落,角膜伤口均可看见线状白斑。组织病理学检查光镜示缝线组术后早期角膜伤口炎细胞浸润,角膜上皮植入;医用胶组术后早期炎细胞浸润不明显,无角膜上皮植入。术后30d2组角膜伤口成纤维母细胞和炎细胞均明显减少,纤维细胞增多。术后90d伤口组织愈合。结论医用胶可有效治疗角膜穿通伤。

Objective To investigate the feasibility of chemical tissue adhesive（2-Octyl Cyanoacrylate） for corneal penetrating wound. Methods Thirty-five Japanese rabbits were used in this study. Right eyes were cyanoacrylate adhesive group and left eyes were suture group. At the 3 days,7 days,14 days,30 days and 90 days after the surgery, the conditions of conjunctiva and anterior chamber were observed by Slit-lamp biomicroscopy after surgery;The condition of corneal wound healing and cyanoacrylate adhesive degradation were observed;The tissue of corneal wounds were observed by light microscope. Resuits The medical adhesive quickly occluded the corneal penetrating wounds during operation. Haze was found in the cornea of both groups at the 3 days after surgery.At the 7 days after the surgery,more neovascularizaton was found in cyanoacrylate adhesive group than in suture group. Then most was disappeared in suture group and two or three still remained in cyanoacrylate adhesive group at the 30 days after surgery. At the 90 days after surgery,neovascularization of both groups were almost absorbed; Medical adhesive was degraded and scar was found. Histopathological examination showed that inflammation and corneal epithelium transplantation were observed in suture group, but not significant in adhesive group. Conclusion Cyanoacrylate can be used in the treatment for corneal penetrating wound.