羊膜移植治疗眼表烧伤的临床观察  

Clinical analysis of amniotic membrane grafting for ocular surface burn

作　　者：朱俊东[1] 谢丽莲[1] 陈文芳[1] 

机构地区：[1]郴州市第一人民医院眼科,湖南郴州423000

出　　处：《中华眼外伤职业眼病杂志》2013年第3期187-189,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价羊膜移植治疗眼表化学烧伤及热烧伤的临床疗效。方法收集我院眼部化学及热烧伤28例（36眼），行低温保存羊膜移植术治疗，随访6～24个月。术后观察视力，羊膜移植片情况，角膜恢复情况及角膜上皮修复时间，并发症。结果术后视力提高者24眼（66．7％），不变者9眼（25．O％），降低者3眼（8．3％）。羊膜移植片情况：36眼中羊膜覆盖成活29眼，成活率达80．6％。角膜恢复情况：36眼中角膜最终恢复透明3眼，角膜薄翳12眼，角膜斑翳14眼，角膜白斑5眼，角膜穿孔2眼。角膜上皮愈合时间：34眼角膜上皮1—4周全部愈合。2眼经治疗后失败，角膜穿孔，行眼球摘除术。结论低温保存羊膜移植术是治疗眼表化学及热烧伤的有效方法。但对于重度眼烧伤患者可能需行多次羊膜移植术才能保全眼球。Objective To evaluate the clinical curative effect of amniotic membrane grafting for ocular chemical burn and thermal burn. Methods We collected 28 patients （36 eyes） with ocular chemical and thermal burn, which had been treated with amniotic membrane grafting in our hospital. The follow-up time ranged from 6 months to 24 months. The postoperative visual acuity, the condition of amniotic mem- brane transplant, renovation of cornea, healing time of corneal epithelium and complications were observed. Results Postoperative corrected visual acuity was improved in 24 eyes （66.7%）, it was not changed in 9 eyes（25.0% ）, the visual acuity declined in 3 eyes （8.3%）. The amniotic membrane survived in 29 eyes and the survival rate was up to 80.6%. The cornea of 3 eyes recovered to transparent. Nebula emerged in 12 eyes eventually. Corneal macula emerged in 14 eyes. 5 eyes ended up with leukoma. 2 eyes resulted in cornea perforation. The corneal epithelium of 34 eyes recovered entirely within 1 to 4 weeks. 2 eyes failed after therapy. Conclusion Amniotic membrane grafting is an effective method to deal with ocular surface burn. But for severe burned eyes, several times of amniotic membrane transplantation need to be done for preserving eyeball.

关 键 词：眼烧伤 眼表重建 羊膜 移植 

分 类 号：R779.6[医药卫生—眼科]