深低温保存羊膜在結膜重建中的臨床應用

目的評價深低温保存羊膜移植進行結膜重建的手術療效,并分析羊膜移植結膜重建手術成功的基本條件和具體手術方法與操作要點.方法用深低温保存的羊膜治療43例結膜整形患者.無眼球結膜囊狹窄10例,大面積結膜腫瘤13例,瞼球粘連9例,復發性胬肉7例,并嘗試對少數病例(4例)義眼座暴露,進行羊膜修補.結果隨診6～18個月,總治愈率達88.64%,無眼球結膜囊狹窄的治愈率為80%,瞼球粘連的治愈率達88.89%,大面積結膜腫瘤和復發性胬肉的治愈率皆為100%,而應用深低温保存羊膜修補羲眼座暴露,治愈率祗有50%.結論深低温保存的羊膜是一種有良好發展前景的生物材料,羊膜移植結膜重建術後整形外觀良好.在具體實踐中,結膜重建的手術效果不僅與羊膜的制備和保存有關,而且受手術方式的選擇,手術操作技巧以及術後處理的强烈影響.

The clinical application of preserved human amniotic membrane for conjunctival reconstruction in deep hypothermia

Objective To evaluate the efficacy of preserved human amniotic membrane for conjunctival reconstruction in deep hypothermia and to analyze the methods of surgery. Methods 43 patients with conjunctivoplasty who underwent preserved amniotic membran transplantation were induded. Preserved human amniotic membrane transplantation was performed on 10 patients without conjunctival sac constriction, 13 patients with large conjunctival tumor, 9 patients with symblepharon, 7 patients with recurrent pterygium and 4 patients with orbital implant exposure. Results 39 cases had satisfactory effects (88.86%) during the follow-up periods of 6~18 months, including 8 patients with conjunctival sac constriction, 13 patients with large conjunctival tumor, 8 patients with symblepharon, 7 patients with recurrent pterygium and 2 patients with orbital implant exposure. Conclusion Preserved human amniotic membrane is a promising biological material. The outlook of patients is good. The effect of transplantation is not only related to the preparation of amniotic membrane, but also is influenced by the surgical procedure, surgical techniques and management after operation.