生物羊膜眼片的研制及其在早期眼灼伤治疗中的应用

Development of biological amnion eye piece and its application in the early treatment of ocular burns

目的探讨应用生物羊膜眼片治疗早期眼化学灼伤的可行性，初步观察治疗效果。方法采取病例前瞻性对照研究。将2012年6月至2014年6月，在解放军180医院眼科就诊的36例39只眼重度眼表化学灼伤患者按入院时间先后分为对照组和实验组，对照组20例21只眼采取常规羊膜遮盖手术治疗，实验组16例18只眼采取生物羊膜眼片进行羊膜遮盖治疗，根据病情随时更换眼片。观察两组手术时间、羊膜下积液发生率、结膜肉芽组织发生率、睑球粘连发生率以及眼表上皮化时间的差异。结果实验组平均手术时间为（6.5±2.3）min；术后未发生羊膜下积液（0/18）；结膜表面肉芽组织形成率5.6%；睑球粘连发生率5.6%；眼表组织上皮化时间（22.1±10.6）d。对照组平均手术时间为（36.6±5.4）min；术后羊膜下积液发生率19.0%；结膜表面肉芽组织形成发生率为33.3%；睑球粘连的发生率47.6%；眼表组织上皮化时间（34.6±12.4）d。实验组与对照组进行比较，以上差异均有统计学意义（P〈0.05）。结论生物羊膜眼片安装简便，效果确切，并发症少，可形成储备，能满足批量眼灼伤患者的救治需求。

Objective To investigate the feasibility of using amniotic membrane eye piece for early ocular surface chemical burns, and observed the initial clinic effects. Methods Thirty-six cases （39 eyes） with severe ocular chemical bum were randomly divided into experimental group and control group, 16 cases （18 eyes） as the experimental group received amniotic membrane eye piece covering; 20 cases （21 eyes） as the control group received conventional amniotic covering surgery. The results at the aspects of the surgical time, hydrops, conjunctive granulation tissue forming, symblephaton and ocular surface epithelization time between the two groups were compared. Results In experimental group; the average operation time was （6.5±2.3） min. the incidence rate of hydrops was none （0/18）; the incidence rate of conjunctival granulation tissue forming was 5.6%; The incidence rate of symblepharon was 5.6%; ocular surface tissue epithelial time was （22.1±10.6） d. The corresponding data in control group were （36.6±5.4）min, 19.0%, 33.3%, 47.6%, （34.6±12.4） d. respectively. The differences between them were statistically significant （P 〈0.05）. Conclusions Compared with traditional amniotic membrane covering, the biological amnion eye piece is performed easily, with exact effect, fewer complications, so that it can easily form a strategic reserve to meet the treatment needs of mass burns of ocular surface.