羊膜移植治疗眼烧伤疗效的观察

THERAPEUTIC EFFECT OF AMNIOTIC MEMBRANE TRANSPLANTATION FOR OCULAR BURN

目的 评价羊膜移植治疗眼部烧伤的疗效。 方法 2 0 0 0年 10月～ 2 0 0 2年 5月 ,对 2 0例患者 (2 8眼 )采用羊膜移植治疗眼烧伤 ,其中碱烧伤 6例 (10眼 ) ,酸烧伤 8例 (10眼 ) ,热烧伤 6例 (8眼 )。年龄 8～ 4 5岁 ,平均 2 8.6岁。烧伤部位包括角膜、结膜。受伤至手术时间 1～ 2 1天 ,平均 10天。 结果 2 8眼术后 3～ 7天眼部炎症控制 ,角、结膜均未见继续溶解 ,无穿孔 ,无虹膜萎缩 ,视力有不同程度提高 ;16眼角膜恢复透明 ,4眼角膜白斑 ,8眼全角膜浑浊。全部患者均保存了眼球 ,眼表稳定 ,无免疫排斥反应及继发感染发生。 结论 羊膜移植可以减轻炎性反应 ,减少新生血管的生成 ,抑制纤维组织增生 ,对重建眼表功能及保存眼球有较高的价值 ,可有效地用于眼部烧伤的治疗 ,烧伤后手术愈早效果愈好。

Objective To evaluate the therapeutic effect of amniotic membrane transplantation( AMT) for ocular burn. Methods Twenty patients with ocular burn(28 eyes) were treated with amniotic membrane transplantation. Of them, there were 6 cases of severe alkali burn(10 eyes), 8 cases of severe acid burn(10 eyes), and 6 cases of thermal burn( 8 eyes). Results In 28 eyes, ocular inflammation was controlled after 3 7 days of surgery; no continued dissolution, perforation and iris atrophy were found. There were corneal transparency in 16 eyes, keratoleukoma in 4 eyes, and total corneal opacity in 8 eyes. All eyeballs were saved and had stable ocular surface. There was no allograft immune rejection and secondary infection. Conclusion Amnitic membrane transplantation can relieve the inflammatory reaction, reduce the growth of blood vessel and restrain the proliferation of fibrous tissue. It is an effect surgical method for ocular burn in reconstruction of ocular surface and salvage of eyeball.