尿激酶角膜接触镜辅助羊膜移植治疗严重角膜烧伤的临床研究  

Clinical Research of Amnion Transplantation Combined with Urokinase and Contact Lenses for Treatment of Severe Corneal Burns

作　　者：赵恳 李劼 孙明 张厚洪 夏欢 

机构地区：[1]湖北省大冶市人民医院眼科,湖北大冶435100

出　　处：《武汉大学学报（医学版）》2011年第2期257-260,共4页Medical Journal of Wuhan University

摘　　要：目的:探讨尿激酶和角膜接触镜对急性期严重角膜烧伤羊膜重建的临床治疗可行性和疗效。方法:对63例(65眼)严重角膜烧伤的患者,随机对其中33眼作为治疗组,采用尿激酶(0.5 ml,3 000 U)球结膜下注射,每日1次,连续7-10 d,择机羊膜移植术并配戴软型角膜接触镜,共10-15 d,其余32眼作为对照组,羊膜眼表重建,术后观察6-12月,平均(8±3)月。结果:所有病例均保留了眼球。治疗组33眼中27眼角结膜烧伤创面愈合,角膜基本透明,遗留薄翳或部分血管翳,无眼球摘除病例,治愈率81.82%;对照组32眼中18眼治愈,有3例眼球萎缩病例,治愈率为56.25%。两组比较差异有统计学意义(χ2=4.985,P<0.05);角膜上皮修复时间,治疗组(30.35±5.34)d,对照组(45.39±8.09)d(t=9.006,P<0.01)。羊膜重建次数,治疗组(1.65±0.36)次,对照组(2.05±1.06)次(t=2.080,P<0.05)。结论:羊膜移植早期应用于急性期严重角膜烧伤眼表重建有效,尿激酶和角膜接触镜能改善角膜缘血液循环,增强重建羊膜稳定性,促进角膜上皮修复,为后期角膜复明创造条件。Objective： To investigate the possibility and evaluate the efficacy of the usage of urokinase and contact lenses for treatment of severe corneal burns at acute stage which reconstructed by amnion.Methods： Sixty-three cases（65 eyes） of severe corneal burn were divided into two groups randomly.The treatment group（33 eyes） were treated with subconjunctival injection of urokinase（0.5 ml,3 000 U,qd,7-10 days）,under went amnion grafting operation and wear with soft corneal contact lens for 10-15 days.Control group（32 eyes） only treated with amnion grafting.All patients were followed up for 612 months（mean 8±3 months）.Results： The eyeballs were saved in all cases.The burn wound of 27 eyes in the treatment group（33 eyes） were healed.The transparency of corneas restored mostly,only partial nebula or pannus remained.The recovery rate was 81.82%.18 eyes in the control group 32 eyes were healed,while atrophia bulbi happed in 3 cases.The recovery rate was 56.25%.There was a significant difference between the two groups（χ2=4.985,P0.05）.Corneal epithelium healed within（30.35±5.34） days postoperatively in the treatment group,while within（45.39±8.09） days in the control group（t=9.006,P0.01）.Number of operations performed about（1.65±0.36） times in the treatment group,while about（2.05±1.06） times in the control group（t=2.080,P0.05）.Conclusion： Amniotic membrane transplantation has advantages for severe corneal burns treatment at acute stage.Urokinase and contact lenses can improve the blood circulation of the corneal limbus,strengthen the stability of the amnion,and promote the corneal epithelium to heal,which could be beneficial to regain eyesight later.

关 键 词：尿激酶 角膜接触镜 羊膜移植 角膜烧伤 

分 类 号：R772.21[医药卫生—眼科]