中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (11): 1994-1997.doi: 10.3969/j.issn.1673-8225.2011.11.023

• 组织构建细胞学实验 cytology experiments in tissue construction • 上一篇    下一篇

新鲜羊膜移植治疗重症角膜溃疡

张晓辉，孙乃学，王  峰   

  1. 西安交通大学医学院第二附属医院眼科，陕西省西安市  710004
  • 收稿日期:2010-08-26 修回日期:2010-12-26 出版日期:2011-03-12 发布日期:2011-03-12
  • 作者简介:张晓辉☆，男，1973年生，陕西省西安市人，汉族，西安交通大学在读博士，主治医师。主要从事角膜病、青光眼、眼前段的研究。 tonyzxh0324@ 163.com

Fresh amniotic membrane transplantation for the treatment of severe keratic ulcer

Zhang Xiao-hui, Sun Nai-xue, Wang Feng   

  1. Department of Ophthalmology, Second Affiliated Hospital, Xi’an Jiaotong University Medical School, Xi’an  710004, Shaanxi Province, China
  • Received:2010-08-26 Revised:2010-12-26 Online:2011-03-12 Published:2011-03-12
  • About author:Zhang Xiao-hui☆, Studying for doctorate, Attending physician, Department of Ophthalmology, Second Affiliated Hospital, Xi’an Jiaotong University Medical School, Xi’an 710004, Shaanxi Province, China tonyzxh0324@163 com

PDF

573

被引次数

7

摘要：

背景：羊膜具有抗原性低、促进眼表上皮化修复、减轻炎性反应、抑制纤维组织增生和新生血管形成等作用。在修复角膜缺损区的创面，可提供一个理想的基底膜，使其迅速上皮化和创口愈合。
目的：新鲜羊膜移植治疗重症角膜溃疡的安全性及其临床疗效。
方法：纳入非感染性继发角膜溃疡6例(6只眼)和感染性原发角膜溃疡8例(8只眼)，共14例临床连续住院患者。非感染性角膜溃疡行单纯新鲜羊膜移植(6只眼)，感染性角膜溃疡羊膜移植联合碘酊烧灼(8只眼)。移植后裂隙灯显微镜下观察角膜溃疡的愈合过程，角膜透明性的变化，移植羊膜存活的时间。
结果与结论：新鲜羊膜植片未发生排斥反应。14例重症角膜溃疡移植治疗后病情缓解，未发生角巩膜穿孔、坏死等严重并发症。其中非感染性角膜溃疡组1 只眼溃疡未愈合。角结膜未发生进行性溶解、穿孔，视力无提高。随访期间溃疡未出现复发及严重的并发症。提示，新鲜羊膜移植治疗重症角膜溃疡是一种有效、安全的方法。

关键词: 新鲜羊膜, 移植, 重症角膜溃疡, 角结膜, 溃疡

Abstract:

BACKGROUND: Amnion has many beneficent effects, including low antigen expression, promoting superficial epithelium restoration, relieving inflammation reaction, prohibiting fibrous tissue proliferation and neovascular formation. On corneal defects, amnion can provide an ideal basal membrane to quickly heal the wounds by epithelization.
OBJECTIVE: To investigate the safety of fresh amniotic membrane transplantation for severe keratic ulcer, and evaluate its clinical efficacy.
METHODS: A total of 14 cases of clinical inpatients continuously on treatment were selected, including 6 cases (6 eyes) of secondary non-infective corneal ulcer and 8 cases (8 eyes) of primary infective corneal ulcer. The 6 eyes had been treated with fresh amniotic membrane transplantation, and 8 eyes with amnion transplantation combined with iodine tincture cauterization. The healing process of corneal ulcer, corneal transparency alterations and amniotic existing time were examined under slit-lamp microscope.
RESULTS AND CONCLUSION: No rejection reaction occurred in fresh amniotic implants. A total of 14 cases of severe corneal ulcer convalesced post-operatively and ulceration was restored. None of kerato-conjuntival epithelium progressively melted or perforated, with no improvement in visual acuity in all cases. During the follow up no ulcer relapsed or severe complications were found. Fresh amniotic membrane transplantation can effectively and securely treat severe keratic ulcer.

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