早期清创联合羊膜移植治疗严重眼表热烧伤

目的观察早期清创联合羊膜移植治疗严重限表热烧伤的效果。方法16例（24只眼）Ⅳ度眼表热烧伤的患者入院后第2天即行眼表清创联合羊膜移植手术治疗，术后综合使用药物控制感染和炎症，促进愈合。结果术后随访1年，16例（24只眼）无1例角膜穿孔。疆度烧伤者视力大于0．1的占100％，大于0．3占印％。Ⅳ度烧伤者视力小于0．1者占42．1％，0．1～0．3者占47．4％，大于0．3者占10．5％。睑球粘连16例（16只眼），Ⅲ度1只眼，Ⅳ度15只眼，粘连发生率为66．67％，其中广泛粘连（〉1／2结膜囊）发生率16．67%，部分粘连（1／2～1／4结膜囊）20．8％，局部粘连（〈1／4结膜囊）29．2％。结论早期清创联合羊膜移植治疗严重眼表热烧伤，可以促进愈合，减少并发症，可作为重建眼表的第一步。

Early debridement and amniotic membrane transplantation for the treatment of severe ocular surface thermal burns

Objective To observe the effect of early debridement and tunniotic membrane transplantation for the treatment of severe ocular surface thermal burns. Methods 16 cases （24 eyes） with grade IV ocular surface thermal burns receive debridement and amniotic membrane transplantation surgery in 24 hours after admission, and drugs were used to control infection and inflammation and to promote healing after surgery. Results 1 year postoperative follow-up, 16 cases of 24 without a case of corneal perforation. HI-degree burns greater than 0.1 visual acuity of 100%, 60% greater than 0. 3. Ⅳ degree burns of less than 0.1 visual acuity accoanted for 42.1%, 0. 1 - 0.3 47.4%, greater than 0.3 accounted for 10.5%. 16 cases of symblepharon,Ⅲ degree 1, Ⅳ degree in 15 cases, adhesions occurred in 66.67 percent rate, in which extensive adhesions （ 〉 1 / 2 conjunctival sac） the incidence of 16.67 percent, and some adhesion （ 1 / 2 conjancrival sac - 1 / conjanctival sac 4） 20.8%, partial adhesion （ 〈 1 / 4 conjanctival sac） 29.2%. Conclusion Early debridement and amniotic membrane transplantation for the treatment of severe ocular surface burns hot, can promote healing and reduce complications, can be used as a first step towards the reconstruction of ocular surface.