羊膜移植联合自体角膜缘干细胞移植治疗眼部烧伤

Effects of amniotic membrane transplantation combined with limbal stem cell autograft transplantation on ocular burns

目的:探究羊膜移植联合自体角膜缘干细胞移植治疗对眼部烧伤患者眼表修复时间、修复率及并发症的影响。方法:回顾性分析我院行自体角膜缘干细胞移植治疗(对照组)和行羊膜移植联合自体角膜缘干细胞移植治疗(观察组)的各61例61眼眼部烧伤患者临床资料。记录两组术后眼表修复率、修复时间、术后12wk视力情况及并发症发生情况(睑球粘连、角膜新生血管、角膜溶解溃疡),并比较两组术前及术后2wk细胞因子[血管内皮生长因子(VEGF)、转化生长因子-β1(TGF-β1)、胰岛素样生长因子-1(IGF-1)]水平差异。结果:观察组术后眼表修复率高于对照组(P<0.05),且修复时间低于对照组(P<0.05)。术后12wk时,观察组视力情况明显优于对照组(P<0.05)。观察组术后并发症总发生率明显低于对照组(P<0.05)。术后2wk时,两组血清VEGF、TGF-β1、IGF-1水平均较术前升高(P<0.05),且对照组高于观察组(P<0.05)。结论:羊膜移植联合自体角膜缘干细胞移植对眼部烧伤患者治疗效果显著,可促进患者眼表修复,改善术后视力,调节患者角膜血管新生情况,降低术后并发症风险。

AIM： To investigate the effects of amniotic membrane transplantation combined with limbal stem cell autograft transplantation on ocular surface repair time,repair rate and complications in patients with ocular burns.METHODS： The clinical data of each 61 cases（ 61 eyes） of patients with ocular burns who were treated by limbal stem cell autograft transplantation（ control group） or amniotic membrane transplantation combined with limbal stem cell autograft transplantation（ observation group） were retrospectively analyzed. The postoperative ocular surface repair rate,repair time,and visual acuity and complications（ symblepharon, corneal neovascularization, and keratohelcosis） at 12 wk after operation were recorded in the two groups,and the levels of cytokines [vascular endothelial growth factor（ VEGF）,transforming growth factor-β1（ TGF-β1）, insulin-like growth factor-1（ IGF-1） ] were compared between the two groups before operation and at 2 wk after operation.RESULTS： The postoperative ocular surface repair rate in observation group was higher than that in control group（ P〈0. 05） while the repair time was less than that in control group（ P 0. 05）. At 12 wk after operation,the visual acuity in observation group was significantly better than that in control group（ P 0. 05）, and the total incidence rate of postoperative complications in observation group was significantly lower than that in control group（ P〈0. 05）. At 2 wk after operation,the levels of serum VEGF,TGF-β1 and IGF-1 in the two groups were significantly higher than those before operation（ P〈0. 05）,and the levels in control group were higher than those in observation group（ P〈0. 05）. CONCLUSION： Amniotic membrane transplantation combined with limbal stem cell autograft transplantation has significant treatment effects on patients with ocular burns,and it can promote ocular surface repair,improve postoperative visual acuity,and can also regulate corneal neovascularization,and it also has positive significance in reducing the risk of postoperative complications.