羊膜联合自体角膜缘上皮移植治疗早期眼化学伤和热烧伤-.docx

羊膜联合自体角膜缘上皮移植治疗早期眼化学伤和热烧伤*作者：曹燕娜席兴华张艳彬李琦【摘要】目的观察羊膜联合自体角膜缘上皮移植治疗各种早期眼化学伤和热烧伤的临床疗效。方法34例（34眼）因各种酸、碱性化学物质或高温固（液）体物质所致按Roper-Hall分级均在Ⅱ度及Ⅱ度以下病程在2周内的早期轻、中度眼化学伤和热烧伤患者采用新鲜羊膜联合自体角膜缘上皮移植术治疗并随访观察6个月平均4.6个月。结果羊膜联合自体角膜缘上皮移植术后第1～2天患者伤眼疼痛和角膜刺激症状即显著缓解角膜水肿和炎症反应程度明显减轻。随访观察术后角膜创面上皮化大多在2周内完成无明显新生血管增生和假性胬肉及睑球粘连等并发症发生视力较术前显著改善。结论新鲜羊膜联合自体角膜缘上皮移植治疗各种早期轻、中度眼化学伤和热烧伤可迅速缓解伤眼疼痛和角膜刺激症状促进角膜创面上皮化减少新生血管增生和防止睑球粘连等并发症提高治疗效果。【关键词】羊膜角膜缘上皮移植化学伤热烧伤Amnioticmembranecombinedwithkeratolimbalepitheliumallografttransplantationinacutechemicalandthermalinjury【Abstract】ObjectiveToinvestigatetheeffectofamnioticmembranecombinedwithkeratolimbalepitheliumallografttransplantationintheacutephaseofocularchemicalandthermalinjury.Methods34patients(34eyes)within2weeksofinjuryinducedbychemicalorhotsubstanceweretreatedwithfreshamnioticmembranecombinedwithkeratolimbalepitheliumallografttransplantationandallcaseswerefollowedupfor6months.ResultsThepatientsexperiencedrapidreliefofpainwithin1～2dayspostoperativelycorneaedemaandinflammationreactionwerealleviated.Duringthefollow-upof6monthsepithelizationofthecorneawascompletedwithin2weeksandlesscicatricialpterygiumsymblepharonandcorneaneovascularizationcomplicationswerenotedvisualacuitywassignificantlyimproved.ConclusionItiseffectthatamnioticmembranecombinedwithkeratolimbalepitheliumallografttransplantationinchemicalorthermalinjurywithseverelimbalischemiainacutephase.Itmightfacilitaterapidepithelizationandpainreliefwhichcouldpreventandreducethecomplicationsandimprovetheprognosisofthepatients.【Keywords】amnioticmembranekeratolimbalepitheliumtransplantationchemicalinjurythermalinjury眼部化学伤和热烧伤常对结膜和角膜组织造成严重损伤即使损伤程度较轻在早期也常常因为角膜上皮的大面积剥脱和基质水肿等而引起患者伤眼的剧烈疼痛和严重的角膜刺激症状后期则可因角膜上皮的反复剥脱和持续性缺损以及炎症反应等常引起角膜大量新生血管增生和纤维组织修复导致角膜新生血管化和假性胬肉甚至睑球粘连使患者视力严重减退。近年来随着羊膜移植和角膜缘干细胞移植术