保存羊膜移植治疗中、重度眼化学烧伤和热烧伤急性期的作用

Clinic study on amniotic membrane transplantation for moderate and severe chemical or thermal ocular burns

目的讨并分析保存羊膜在眼中、重度化学烧伤和热烧伤急性期的治疗作用以及对晚期并发症的预防作用。方法选择兰州医学院第二附属医院急性化学烧伤和热烧伤的住院患者19例(21眼)根据病情分为中度组(14眼烧伤为Ⅱ～Ⅲ度)和重度组(7眼烧伤为Ⅳ度),入院1周内分别行单纯羊膜移植术和羊膜移植术+自体(异体)角膜缘上皮干细胞移植术。观察早期眼表重建时间,晚期角膜血管化,睑球粘连,视力改善情况。结果中度组的眼表重建时间较重度组短,视力提高较后者明显,差异有显著性意义(P<0.001)。在角膜血管化,睑球粘连等方面也较后者轻。结论羊膜可用于眼中、重度化学烧伤和热烧伤的急性期治疗,其预后效果同眼部损伤程度有直接关系。

Objective To determine whether preserved huma n amniotic membrane(AM)can be used to treat ocular burns in th e acute stage and prevent later complicatio ns.Methods Twenty-one eyes from nineteen patie nts with chemical burns or thermal bu rns were graded into moderate group(14eyes)and severe group(7eyes).They were performed preserved amni otic membrane transplantation and a mniotic mem-brane transplatation +autologous o r heterologous limbal epitheilial s tem cells transplantation,respectively.Observe the time of epitheili aliza-tion,coreal neovascularization,v isual acuity and symblepharon.Results The time of epitheilialization in mi ld group was shorter than in the severe group;the visual acuity impr oved of the moderate was better than s evere group.Compared with the severe group,Corneal neovascu-larization and symblepharon was lig ht relatively in moderate group.Conclusion The preserved human amniotic membra ne can be used as a graft to reconstruct ocular surface in ocular burns at acute stage.The effect is related to the grade of ocular burns.