异种(牛)脱细胞真皮在结膜囊成形术中的临床应用  

Clinical application of xenogeneic(bovine) acellular dermal matrix in conjunctival sac reconstruction

作　　者：高长华[1] 张向荣[1] 周琼[1] 裴重刚[1] 

机构地区：[1]南昌大学第一附属医院眼科,江西省南昌市330006

出　　处：《眼科新进展》2012年第7期648-650,653,共4页Recent Advances in Ophthalmology

基　　金：江西省卫生厅科技计划项目(编号:20121043)~~

摘　　要：目的探讨采用异种(牛)脱细胞真皮作为移植材料行结膜囊成形术的安全性及效果。方法 9例(9眼)眼内容摘出术后结膜囊狭窄患者,行义眼座植入联合结膜囊成形术,术中应用Medpor义眼座作为眼窝填充材料、异种(牛)脱细胞真皮作为结膜生长支架移植材料。义眼座植入后行结膜囊成形术,将异种脱细胞真皮修剪后移植于结膜缺损处,放入眼模,缝合睑缘,术后抗炎治疗3个月拆除睑缘缝线。随访观察6～18个月,平均8个月。结果 9例患者术后均无明显排斥反应,无义眼座暴露;植片色泽逐渐红润,无坏死、脱落及明显收缩,结膜上皮爬行并覆盖植片表面。术后3个月植片近似正常结膜外观,结膜囊成形好,配戴义眼片后患眼外观良好,不滑脱。9例患者中8例效果良好,1例一般。结论采用异种(牛)脱细胞真皮作为结膜囊成形移植材料,手术操作方便,异种脱细胞真皮组织相容性好,结膜囊成形效果满意。Objective To investigate the clinical safety and effect of xenogeneic （bovine） acellular dermal matrix in the treatment of conjunctival sac stenosis. Meth- ods Nine cases（9 eyes） with conjunctival sac stenosis after evisceration of eye were treated with artifical orbital implantation combined with conjunctival sac reconstruc- tion. Medpor was intraoperatively applied as filling material in eye socket and xenogene- ic（bovine） acellular dermal matrix as transplantation material to support conjunctival growth,proceed conjunctival sac reconstruction after artifical orbital implantion, trans- planted acellular dermal matrix to conjunctival coloboma, then enchased eye mode and sutured margopalpebrae, postoperative anti-inflammatory was performed, margopalpe- brae stitiches were taken out at 3 months after operation, all cases were followed up from 6 months to l8 months, 8 months on average. Results All of 9 cases had no significant reject response or Medpor expose ,the graft colour and luster were gradually ruddy, no plant graft was without necrosis or fall off or obvious contraction. Conjuncti- val epithelium crawled and covered the surface of graft. The appearance of graft approx- imated to normal conjunctiva at 3 months after operation, conjunctival sac formed well, the artifical lamel was easy to wear and did not drop, and the appearance looked good. The effects of 8 cases were good and 1 case was general. Conelusion Appling bovine acellular dermal matrix as the transplant material in conjunctival sac reconstruction, the operative procedure is convenient, the biocompatibility of xenogeneic （bovine） a- cellular dermal matrix is good, and the effect of conjunctival sac reconstructions issatisfied.

关 键 词：异种(牛)脱细胞真皮 异种移植 结膜囊狭窄 结膜囊成形术 

分 类 号：R644[医药卫生—外科学]