自体唇腺移植治疗重症角结膜干燥症  

Transplantation of autologous labial salivary glands for severe keratoconjunctivitis sicca

作　　者：陈志远[1] 王静[1] 吴晓霞[1] 连晓萌 刘静明[1] 王璇[1] 

机构地区：[1]首都医科大学附属北京同仁医院口腔科,北京100730

出　　处：《首都医科大学学报》2016年第3期281-285,共5页Journal of Capital Medical University

基　　金：北京市科委北京医药产品和技术重大项目培育研究项目(SKW-ZDPY-2010-001)~~

摘　　要：目的评价自体唇腺移植治疗重症角结膜干燥症的临床效果。方法 16例重症角结膜干燥症患者接受自体唇腺移植,术中自同侧下唇制取唇腺黏膜瓣,将其植于同侧上睑穹隆。所有患者术前进行唾液分泌试验及涎腺核素扫描检查。术前、术后分别测定最佳矫正视力、施墨试验,并对术后主观满意度、人工泪液使用频率、主观症状评分进行评价。结果术后随访时间12个月,自体唇腺黏膜瓣全部存活,下唇创面愈合良好。术后不同时间段所有患者移植侧泪液分泌量均较术前明显增加(P<0.05),主观症状评分和人工泪液使用频率也明显低于术前(P<0.05)。2例患者术后最佳矫正视力有不同程度提高,其余患者未见明显提高。14例患者对术后效果满意,2例满意度一般。结论自体唇腺移植可以增加重症角结膜干燥症患者唾液泪液分泌,明显缓解患者干眼症状。该术式可作为治疗重症角结膜干燥症的一种有效方法。Objective To evaluate the effect of autologous labial salivary glands transplantation in the treatment of severe keratoconjunctivitis sicca. Methods Sixteen patients suffered from severe keratoconjunctivitis sicca underwent the transplantation of autologous labial salivary. The labial gland mucosal flap of the ipsilateral lower lip was harvested and sutured to the ipsilateral upper conjunctival fornix. The best-corrected visual acuity,Schirmer test,need for tear substitutes,the subjective satisfaction and the degree of discomfort were investigated before and at different intervals after surgery. Results Postoperative follow-up for 12 months,the autologous labial gland mucosal flap all survived and the good healing in donor site was achieved. The tear secretion was significantly increased on operated side in all patients after surgery compared with before surgery（ P〈 0. 05）. The need for tear substitutes was significantly reduced and the degree of discomfort significantly was decreased on operated side in all patients after surgery compared with before surgery（ P 〈0. 05）. The best-corrected visual acuity was improved in 2 of 16 cases. 14 of 16 patients were satisfied with the results. Conclusion The autologous labial salivary glands transplantation could increase tear secretion for severe keratoconjunctivitis sicca,relieve the symptoms of patients with dry eye. It was a promising new treatment option for severe dry eye.

关 键 词：角结膜干燥症 自体唇腺黏膜移植 泪液 

分 类 号：R781.5[医药卫生—口腔医学]