干燥生物羊膜移植治疗急性期眼化学烧伤临床效果观察  

Clinical effect of dry biological amniotic membrane transplantation on acute ocular chemical burn

作　　者：李莹 陈颖欣 高明宏 LI Ying;CHEN Ying-xin;GAO Ming-hong(Jinzhou Medical University General Hospital of Northern Theater Command Postgraduate Training Base,Jinzhou 121000,China;Department of Ophthalmology,General Hospital of Northern Theater Commard,Shenyang 110016,China)

机构地区：[1]锦州医科大学北部战区总医院研究生培养基地,辽宁锦州121000 [2]北部战区总医院眼科,辽宁沈阳110016

出　　处：《临床军医杂志》2020年第3期281-283,共3页Clinical Journal of Medical Officers

摘　　要：目的观察干燥生物羊膜移植治疗急性期眼化学烧伤的临床效果。方法选取北部战区总医院2017—2019年收治的21例(29眼)接受干燥生物羊膜移植治疗的急性期眼化学烧伤患者为研究对象。随访3~6个月,观察患者羊膜植片情况、角膜上皮愈合情况、视力和角膜透明度,以及角膜血管化和睑球粘连形成情况。结果所有患者羊膜移植后,羊膜植片贴附良好,呈半透明,缝线在位。羊膜移植术后第1天,患者眼部刺激症状有不同程度缓解,疼痛感和眼表炎症均有所减轻。羊膜植片在术后1~3周逐渐溶解,均未发生排斥反应。18眼(62.1%)角膜上皮愈合,角膜荧光素钠染色上皮无着染,愈合时间为7~28 d;11眼(37.9%)角膜缘缺血改善,其中,6眼在羊膜移植后1个月上皮仍缺损,角膜缘缺血范围>1/4钟位。术后第1天,患者视力均无提高,甚至有不同程度下降。术后5~7 d,患者视力有所提高。术后3个月,患者视力趋于稳定。18眼术后2周角膜水肿较术前减轻,1个月后角膜恢复透明。24眼未发生角膜血管化及睑球粘连;2眼在术后2周羊膜植片溶解时发现角膜缘缺血苍白,结膜和巩膜有溶解倾向,行睑缘缝合术,术后3个月角膜上皮愈合,角膜血管化形成;1眼在术后1个月出现新生血管,术后2个月出现睑球粘连;2眼形成角膜云翳。结论干燥生物羊膜移植是治疗急性期眼化学烧伤的有效手段,对于患者视力恢复、角膜上皮完整、预后改善、并发症减轻具有显著作用。Objective To investigate the clinical efficacy of amniotic membrane transplantation in the treatment of acute ocular chemical burn.Methods A retrospective study was performed on 21 patients(29 eyes)who received dry biological amniotic membrane transplantation during 2017-2019.The patients were followed up for 3-6 months to observe amniotic membrane graft,corneal epithelial healing,visual acuity and corneal transparency,as well as corneal vascularization and the formation of symblepharon.Results After amniotic membrane transplantation in all patients,the amniotic membrane grafts were attached well,showing translucent and suture lines.On the first day after amniotic membrane transplantation,the patient's eye irritation symptoms were relieved to varying degrees,and the pain and ocular surface inflammation were alleviated.The amniotic membrane grafts were gradually dissolved 1 to 3 weeks after the operation,without rejection.In 18 eyes(62.1%),the corneal epithelium was healed,and the corneal epithelium stained with fluorescein sodium was non-stained,and the healing time was 7-28 days.In 11 eyes(37.9%),limbal ischemia was improved,among which 6 were still epithelial deficient one month after amniotic membrane transplantation,and limbal ischemia ranged more than 1/4 clock position.On the first day after the operation,the visual acuity of all patients was not improved,and even decreased to different degrees.The visual acuity of the patients was improved 5-7 days after surgery.Three months after the operation,the patient's vision tended to be stable.Corneal edema was reduced 2 weeks after 18 eyes operation,and corneal transparency was restored 1 month later.No corneal vascularization and symblepharon occurred in 24 eyes.During the dissolution of amniotic membrane graft 2 weeks after the operation,corneal limbal ischemia and paleness were found in 2 eyes,and conjunctiva and sclera tended to dissolve.Blepharoplasty was performed,and corneal epithelium was healed and corneal vascularization formed 3 months after the operati

关 键 词：干燥生物羊膜移植 眼化学烧伤 急性期 

分 类 号：R779[医药卫生—眼科]