羊膜移植治疗早期眼表碱性化学伤的临床观察

Clinical observation of amniotic membrane transplantation for the treatment of early alkaline chemical burn of ocular surface

目的:探讨新鲜人羊膜移植术对中重度早期眼表碱烧伤的临床效果。方法:对32例41眼中重度早期眼表碱烧伤进行单层或多层羊膜移植术,联合局部给予典必殊眼液及眼膏点眼,术后随访6～18(平均12)mo。结果:Ⅱ～Ⅲ度眼表碱烧伤29眼,角膜上皮愈合良好。Ⅳ度烧伤12眼,6眼角膜上皮愈合良好,5眼发生持续性上皮糜烂,1眼角膜溶解穿孔,所有病例均无排斥反应及睑球粘连。结论:单纯羊膜移植术是Ⅱ～Ⅲ度早期眼表碱烧伤简单有效的治疗方法,但对Ⅳ度烧伤者疗效欠佳。

AIM： To investigate the clinical results of fresh human amniotic membrane transplantation in treatment of moderately severe early alkaline burn of ocular surface. METHODS： Thirty-two patients （ 41 eyes ） with moderately severe early alkaline burn of ocular surface underwent single-layer or multilayer amniotic membrane transplantation combined with local use of tobradex eye drops and eye ointment. Patients were followed up for 6- 18 months, average 12 months. RESULTS： Corneal epithelium of 29 eyes with Ⅱ -Ⅲ degree alkaline burn of ocular surface were in good healing. In 12 eyes with Ⅳ degree burns , corneal epithelial were in good healing in 6 eyes; sustained epithelial erosion occurred in 5 eyes; Perforation and melting of the cornea occurred in 1 eye; and no rejection and symblepharon occured. CONCLUSION： Amniotic membrane transplantation alone is a simple and effective method for Ⅱ-Ⅲ degrees alkaline burn of ocular surface, but the efficacy for Ⅳdegree burn seems to be below the mark.