集体发生眼部盐酸烧伤的急救与治疗

The emergency treatment for hydrochloric acid burn in eye

目的 探讨集体发生眼部严重盐酸烧伤的急救和后续治疗。方法 对 2 2例 44眼进行了急救和治疗 ,并加用碱性成纤维细胞生长因子———贝复舒 ,3眼施行羊膜移植。结果 随访观察 15月 ,Ⅰ度烧伤 11眼及Ⅱ度烧伤 15眼视力均恢复正常 ,Ⅲ度烧伤 12眼 ,视力均在 0 5以上 ;Ⅳ度烧伤 6眼 ,3眼视力 0 .2～ 0 .3 ,2眼视力 0 .1～ 0 .15 ,1眼 0 0 4。结论 严重盐酸烧伤经急救后 ,在综合治疗基础上加用碱性成纤维细胞生长因子能加速创面愈合 ,严重者可通过羊膜移植改善眼表功能 ,防止睑球粘连和穿孔 。

Objective To investigate the first aid and following treatment of serious hydrochloric acid(HA) burns in eye,and to evaluate the effect of recombinant bovine basic Fibroblast Growth Factor(bFGF),amniotic membrane transplantation(AMT) for HA burn in eye.Methods In 22 cases of 44 eyes(degree Ⅰ burn 11 eyes,degree Ⅱ 15 eyes,degree Ⅲ 12 eyes and degree Ⅳ 6 eyes).All the cases had administered the first aid and following treatment.Which include using bFGF eye drops,AMT(3 eyes) or combined with either corneal limbal stem cell transplantation(1 eye).Results The follow up period was 15 months.In degree Ⅰ Ⅱ burn cases,26 eyes recovered normal visual acuity(VA).In degree Ⅲ,12 cases had VA of 0.5 or better.In degree Ⅳ,3 eyes had VA of 0.2 0.3,2 eyes had VA of 0.1 0.15,one eye of 0.04,their cornea remains serious haze and neovascularization.No infection,corneal progressive melt and perforation,symblepharon were seen in all cases.Conclusion First aid is the most important for serious HA burn.Using bFGF Eye Drops can effectively speed up the wound healing.To serious burns cases,fresh amniotic membrane can be used to reconstruct ocular surface,it can effectively prevent symblepharon,corneal perforation and reduce neovascularization.