甘油保存羊膜在结膜重建中的临床应用

Clinical application of preserving the amnion in glycerin during the reconstruction of conjunctiva

目的:分析甘油保存羊膜移植重建结膜的基本条件和手术方法,并评价手术疗效。方法:对11例不同眼部疾病患者采用甘油保存人羊膜进行移植手术以重建结膜。其中4例为无眼球结膜囊狭窄,2例为眼球萎缩结膜囊狭窄,1例为大面积结膜肿瘤,2例为眼球粘连,2例为下眼睑基底细胞癌。结果:在11例中无1例感染,10d后移植的羊膜透明,缝合处结膜向羊膜上爬行,1mo后新生的结膜上皮完全覆盖移植区,3mo后2例眼球粘连患者重新出现不同程度的睑球粘连,治疗率为91%。结论:甘油保存人羊膜移植手术可有效重建结膜,但其基本条件为受体眼有一定量的健康球结膜及有血液供应的植床与羊膜植片紧密贴附。

AIM： To analyze the basic conditions and surgery methods of reconstructing conjunctiva by transplanting the amnion preserved in glycerin and to evaluate its clinical application value. METHODS： Eleven cases with different eye diseases were transplanted with the human amnion preserved in glycerin for reconstructing conjunctiva, in which 4 cases were anophthalmia conjunctival sac straitness, 2 were eyeball atrophy conjunctival sac straitness, 1 case was conjunctiva tumor in large region, 2 were eyeball conglutination, and 2 were lower eyelid basal cell carcinoma. RESULTS： There was no inflammation in 11 cases after surgery. The transplanted conjunctiva turned transparent and the conjunctiva at sewing location crawled to amnion 11 days after surgery. One month late, the neonatal conjunctiva covered transplanting region completely. Three months late, 2 cases with eyeball conglutination presented conglutination between eyeball and eyelid in different degrees. The healing rate reached 91%. CONCLUSION： The method of transplanting the human amnion peserved in glycerin can reconstruct conjunctiva efficiently, but only when receptor eye must have a certain quantity of healthy bulbar conjunctiva and a transplanting bed with blood supplying adhibited by transplanted amnion dosely.