异种脱细胞真皮基质在结膜囊成形术中的应用  

Application of allograft acellular dermal matrix in conjunctival sac plasty surgery

作　　者：石璐[1] 章余兰[1] 

机构地区：[1]南昌大学第二附属医院眼科,江西省南昌市330006

出　　处：《眼科新进展》2017年第1期80-82,共3页Recent Advances in Ophthalmology

摘　　要：目的观察在治疗睑球粘连、结膜囊狭窄等结膜囊成形术中应用异种脱细胞真皮基质的临床疗效。方法对2012年1月至2016年1月我科收治的睑球粘连患者13例(13眼)和结膜囊狭窄患者63例(63眼),共76例(76眼)行粘连分离加异种脱细胞真皮基质移植术,术后随访6~12个月,观察手术效果。结果术后1个月,异种脱细胞真皮基质贴附良好,新生结膜爬行其上,睑球无粘连,结膜囊成形良好,总有效率100%(76/76)。术后40 d至2个月,异种脱细胞真皮基质溶解吸收后,3例(碱烧伤2例,重度沙眼1例)睑球粘连患者,重新出现睑球粘连,5例重度结膜囊狭窄伴眼睑外翻重新出现结膜囊狭窄、睑外翻均于3个月后再次行粘连分离+异种脱细胞真皮基质移植术,效果良好;其余68例术后2个月异种脱细胞真皮基质完全溶解吸收,睑球无粘连,结膜囊成形良好,总有效率89.5%(68/76)。随访6~12个月,76例患者均达到满意效果,无复发。结论异种脱细胞真皮基质是一种新的、良好的眼结膜替代生物膜,可以用于结膜囊成形手术。Objective To observe the therapeutic effects of allograft acellular dermal matrix application in surgery for the conjunctival sac plasty such as symblepharon, conjunctival sac stenosis. Methods Thirteen patients （ 13 eyes） of symblepharon and 63 patients （63 eyes） of conjunctival sac stenosis that received adhesion separation and transplantation of allograft acellular dermal matrix from January 2012 to January 2016 in our hospital were selected and successfully fonowed up from 6 months to 12 months after operation, and the therapeutic effects were observed. Results Followed up for a month, all the acefiular dermal matrix patch were well adhered, crawled on newborn conjunctiva with adhesion separation, conjunctival sac formed well, the total effective rate was 100% ;Followed up for 40 days to 2 months,acellular dermal matrix were dissolved and absorbed,3 patients whose symblepharon area ≥ 1/2 ocular surface area （2 cases of alkali burn, 1 case of severe trachoma） reappeared symblepharon,5 patients of severe conjunctival sac stenosis ectropion with ectropion reappeared conjunctival sac stenosis,they were received adhesion separation and transplantation of allograft acenular dermal matrix again after 3 months and the surgery effect were well. The remaining 58 patients＇ acellular dermal matrix were dissolved and absorbed completely with adhesion separation, conjunctival sac formed well after 2 months, the total effective rate was 89.5%. Followed up from 6 months to 12 months, 75 patients were received satisfactory postoperative effects without recurrence. Conclusion The allograft acellulax dermal matrix is a new and good alternative for conjunctival biofilms and can be used for conjunctival sac plasty.

关 键 词：异种脱细胞真皮基质 睑球粘连 结膜囊狭窄 结膜囊成形术 

分 类 号：R779.64[医药卫生—眼科]