羊膜为基底的小片状同种异体结膜移植治疗碱烧伤

目的 将羊膜移植与片状同种异体结膜移植相结合重建眼表。方法 新西兰白兔42只，右眼(实验组)、左眼(对照组)上方球结膜碱烧伤后24h分别行以羊膜为基底的小片状同种异体结膜移植和单纯小片状同种异体结膜移植，术后各周行印迹细胞的PAS染色、扫描电镜检查。结果 实验组植片成活率明显高于对照组(P＜0．05)。实验组术后第4周，对照组术后第5周结膜外观、杯状细胞形态数目功能均恢复正常。结论 大面积结膜碱烧伤早期应用羊膜改善异体植片的基底，有利于降低排斥反应，提高植片成活率，达到结膜结构与功能重建之目的。

Treatment of conjunctiva alkali burn by flat allogenic conjunctival transplantation based on amnion membrane

Objective To use amniotic membrane transplantation(AMT) with allogenic conjunctival transplantation(ACT)to reconstruct ocular surface.Methods Bilateral superior ball conjunctiva of New Zealand white rabbits were burned by alkali.Twenty four hours after burning , the right eyes (experiment group) were performed AMT and flat ACT base on the amnion, meanwhile, the left eyes (control group)were done merely flat ACT. PAS and SEM of CI were undertaken on two groups at every week after operation.Results In experimental group, obvious rejection wasn't observed, all grafts lived and extended to surrounding; Their appearance and shape,number, function of goblet cells turned into normal till the forth week. In control group, obvious rejection was found, seven grafts were excluded and falled off, and symblepharon was formed at last. Others lived ,their appearance, shape, number and function of goblet cells were similar to normal conjunctiva till the fifth week. The survival rate showed significant difference between the two groups.Conclusion During the earlier period of conjunctiva alkali burn of large area, amnion membrane transplantation with allogenic conjunctival transplantation can improve allograft's fundus and reduce rejection and enhance allograft's survival rate to reach the aim that small grafts rebuild large defection.