早期新鲜羊膜移植治疗眼部重度碱烧伤临床分析

Clinical analysis of early fresh amniotic membrane transplantation for ocular severe alkali burns

目的:评价早期新鲜羊膜移植术治疗眼部重度碱烧伤的疗效。方法:对48例67眼重度碱烧伤患者按就诊时间分为A,B两组,烧伤0.5h～7d(包括7d)就诊者26例38眼(A组);烧伤7～20d(不包括7d)就诊者22例29眼(B组)。两组均采用新鲜羊膜移植术,术后均配戴软性角膜接触镜。3mo后观察眼表状况。结果:A组:角膜全透明者28眼,半透明者5眼,全混浊者3眼,角膜白斑者2眼,睑球粘连者2眼,有新生血管者2眼,视力≥0.4者28眼,<0.4者10眼;B组:角膜全透明者12眼,半透明者7眼,全混浊者6眼,角膜白斑者4眼,睑球粘连者13眼,有新生血管者15眼,视力≥0.4者11眼,<0.4者18眼。两组结果比较均有统计学意义(P<0.05)。结论:早期新鲜羊膜移植术可以更好的重建眼表,提高视力,是眼部重度碱烧伤的最佳治疗方法。

AIM： To evaluate the early stage of fresh amniotic membrane transplantation for treatment of severe ocular alkali burn. METHODS： Forty-eight cases of 67 eyes with severe alkali burns were divided into A, B groups according to visiting time, 26 cases of 38 eyes burned for 0.5 hours -7 days （including 7 days） were treated for the A group; 22 cases of 29 eyes burned for 7-20 days （not including 7 days） were treated for the B group, both groups were transplanted with fresh amniotic membrane and wore soft contact lenses after operation. The ocular surface conditions and visual acuity were observated after 3 months. RESULTS： There were 28 eyes of full transparent cornea, 5 eyes of semi-transparent, 3 eyes of all muddy and 2 eyes of corneal leukoplakia, and 2 eyes of symblepharon, and 2 eyes of new blood vessels,and the visual acuity of 28 eyes was ≥0.4, 10 eyes 〈0.4 in A group. There were 12 eyes of full transparent cornea, 7 eyes of semi-transparent, 6 eyes of all muddy and 4 eyes of corneal leukoplakia, and 7 eyes of symblepharon, and 15 eyes of new blood vessels, and the visual acuity of 11 eyes was ≥0.4, 18 eyes 〈0.4 in B group. Comparison of the two groups were statistically significant （P〈0.05）. CONCLUSION： Early fresh amniotic membrane transplantation could be better for reconstruction of ocular surface and improving vision, it is the best therapeutic approach for the severe ocular alkali burns.