自体血清和生物羊膜移植及那他霉素三联治疗真菌性角膜溃疡

Triple therapy of fungal corneal ulcer with autologous serum, bio-amniotic membrane transplantation and Natamycin

目的：观察羊膜移植术联合自体血清及那他霉素治疗真菌性角膜溃疡的临床效果。方法：农作物及植物所致真菌性角膜溃疡80例80眼，随机分成治疗组和对照组各40例，治疗组加用白体血清。两组对比观察角膜创面愈合及角膜瘢痕形成情况。所有病例于手术显微镜下彻底清创溃疡灶及坏死的角膜组织，取瑞济生物（8mm×10mm羊膜）基地膜面贴敷于溃疡面，再取（10mm×15mm）较大的生物羊膜覆盖其上。并以10—0尼龙线缝合固定。术后治疗组加自体血清球结膜下注射。结果：局部创面全部愈合69例69眼，11例未愈。治疗组术后6mo角膜瘢痕形成情况，平均视力明显优于对照组。两者比较差异有统计学意义（P〈0．01）。结论：多层羊膜移植加自体血清结膜下注射治疗真菌性角膜溃疡疗效良好。

AIM： To observe clinical effects of the amniotic membrane transplantation combined with autologous serum and Natamycin treatment of fungal corneal ulcer. METHODS： Crops-and plant-caused 80 cases of fungal corneal ulcer （80 eyes） were randomly divided into treatment group and control group with 40 cases in each group, the treatment group was added with autologous serum. Corneal wound healing and corneal scar formation was observed in two groups. All patients underwent surgical debridement of ulcers and necrosis of the corneal tissue lesions under a microscope. Ruiji biological （8mm × 10mm amniotic membrane） base membrane surface patching was taken on the ulcer surface, and （10mm × 15mm） larger biological amniotic membrane was taken to cover it. They were sutured with 10-0 Nylon lines. The treatment group was added by subconjunctival autologous serum injection after surgery. RESULTS： All 69 eyes of 69 cases had local wound healed. Treatment group was better than the control group at corneal scar formation and average visual acuity 6 months after surgery The difference was statistically significant （ P〈 0.01 ）. CONCLUSION： Multilayer amniotic membrane transplantation plus subconjunctival injection of autologous serum treatment of fungal corneal ulcer is good.