自体颌下腺游离移植治疗严重干眼症的实验研究

Experimental Study on the Severe Xerophthalmia Treated by Autologous Free Submandibular Gland Transplantation

目的:观察兔自体颌下腺游离移植术后的泪液分泌及严重干眼症的治疗效果。方法:摘除兔泪腺制成干眼症模型后,实验组通过显微血管吻合技术将自体颌下腺游离移植于颞侧眶区,导管吻合于外下穹窿结膜,对照组不做其它处理。术后观察泪液分泌、眼荧光素染色、光镜检查等。结果:实验组泪液分泌量持续增加,2～3个月基本稳定,角膜荧光素染色减少或消失,两组有显著性差异(P<0.05)。组织病理学检查见对照组的眼表组织有明显的炎症细胞浸润和结构破坏,而实验组的颌下腺则具有较正常的组织结构。结论:自体颌下腺移植能保持持续的分泌功能,阻止实验性兔眼干眼症的发生。

Objective： To study the lacrimal secretion and therapeutic efficacy after the autologous free submandibular gland transplantation to treat severe experimental xerophthalmia.Methods：Animal model of xerophthalmia was founded in rabbits by surgical removal of the lacrimal gland. The free submandibular gland was transplanted to the lateral orbital wall by microvascular anastomosis with duct anastonosis to lateral inferior conjunctival fomix. After operation, tear secretion, fluorescein staining and histological examination were tested.Results： The secretory volume of tears increased continuously in the experimental rabbits and kept stably after 2 to 3 months. The fluorescein staining score of ocular surfue in the experimental rabbits was significantly lower than that in the control rabbits. Severe inflammation and impairments were observed in the control rabbits but not in the experimental rabbits by bistopathologic examination. Conclusion：Free transplantation of submandibular gland to drain saliva into the conjunctival fomix can prevented the rabbits suffering from severe xerophthalmia.