自体颌下腺移植治疗角结膜干燥症实验研究

目的 通过兔自体颌下腺移植试验,研究自体颌下腺移植治疗角结膜干燥症的可行性,移植术中、术后可能发生的问题及解决方法。方法 健康大耳白家兔20只,分成2组。试验组功除泪腺,通过血管吻合移植自体颌下腺至左颞部,导管植入外下穹隆结膜;对照组仅切除泪腺,不移植颌下腺。术后观察2个月,于术后1、2、3、4及8周分别进行施墨试验、移植眼泪液唾液淀粉酶测定、移植颌下腺造影、移植腺体及角膜组织病理学检查。结果 对照组兔术后施墨试验滤纸条长度低于术前,移植组施墨试验滤纸条长度高于术前。移植眼唾液淀粉酶浓度高于术前。移植腺体造影可清楚显示移植颌下腺完好的导管及腺泡结构,组织病理学观察,移植成功腺体结构正常,移植侧角膜无受破坏现象。结论 自体颌腺移植可适当增加角结膜干燥症兔泪液量,移植腺体分泌的唾液不会对眼部结构造成破坏,是治疗角治膜干燥症的有效方法。施墨试验及唾液淀粉酶浓度测定对壑移植腺体是否成活及移植腺体功能具有重要意义。移植颌下腺造影是检查移植腺体结构及功能的一种较好方法。

Autologous submandibular gland transfer for the mangement of xerophthalmia:An experimental study

Objective To investigate free submandibular gland (SMG) transfer as a method of treatment for xerophthalmia;to study the feasibility of this method and the problems that might take place during and after the transfer operation.Methods Vascularized SMG transfer was used as the treatment for xerophthalmia of the rabbits in whih the lacrimal glands had been removed.After transplantation,the schirmer's test,amylase concentration examination of the tears of the transferred side eye,sialography and the histopathological examination of the transferred glands were performed.Results In the control group where the lacrimal glands were removed,the length of schirmer's test filter paper after operation was infiltrated by tears less than that before operation;in the transfer group,the length of the schirmer's test filter paper after operation was more infiltrated than that before operation,and also more than the results of the control groups after operation,the amylase concentration of the transferred sides was higher than that before transplantation,the sialography of the transferred glands showed clearly the normal structure of the ducts and the acini,the results from the histopathological examinations showed that the structure of the transferred hlands was normal and the cornea of the transferred sides had no signs of erosion.Conclusion Autologous SMG transfer might be used as the choice of treatment for xerophthalmia.