组织粘合剂联合羊膜移植在角膜溃疡中的应用研究

Application of tissue adhesive combined with amniotic membrane transplantation to corneal ulcer

目的观察与探讨氰基丙烯酸组织粘合剂联合羊膜移植在角膜溃疡中的临床疗效。方法采用前瞻性临床对照研究,将58例接受角膜溃疡羊膜移植术的患者随机分为两组:粘合组33例,用组织粘合剂粘贴羊膜;缝线组25例,用10-0尼龙线缝合羊膜。比较两组手术时间和术后症状,随访6~12个月,观察局部反应、角膜上皮生长情况及羊膜贴附情况等。结果组织粘合剂组平均手术时间(13.31±2.81)min,比缝线组(18.72±4.33)min明显缩短(P<0.05)。组织粘合剂组术后症状较缝线组轻,羊膜植片较缝线组贴合紧密,其余两组差异无统计学意义。结论角膜溃疡羊膜移植术中使用氰基丙烯酸组织粘合剂粘合羊膜安全、简便,可代替传统的缝线缝合并在一定程度上优于缝线,值得在临床上进一步研究及推广。

Objective To investigate the efficacy of cyanoacrylate tissue adhesive combined with amniotic membrane transplantation in treatment of corneal ulcer. Methods Using a prospective randomized controlled study, 58 patients who accepted corneal ulcer treatment with amniotic membrane transplantation were randomly divided into two groups： adhesive group （33 cases with amniotic membrane adhered using tissue adhesive） and suture group （25 cases with amniotic membrane sutured with 10-0 nylon）. The operation time and postoperative symptoms were compared between the two groups. After the patients were followed up for 6 to 12 months, local reaction, growth of corneal epithelium, and attached condition of amniotic membrane were observed. Results The average operation time of the adhesive group was significantly shorter than that of the suture group [（13.31 ±2.81） min vs （18.72 ± 4.33） min, P 〈 0.05）. The postoperative symptoms of the adhesive group were milder than those of the suture group. The amniotie membrane graft of the adhesive group was tighter than that of the suture group. Conclusions It is safe and simple to use cyanoacrylate tissue adhesive in amniotic membrane transplantation for corneal ulcer. It can replace the traditional suture, and to a certain extent, is even better than suture. It is worth further clinical research and promotion.