| 目的 研究和评估羊膜贴敷对重症眼表烧伤的确切疗效和影响
手术疗效的相关因素。
方法 通过对15例(20眼)Ⅲ-Ⅳ度眼表烧伤眼手术前后视力、
角膜上皮化、角膜缘和瞳孔区角膜血管化程度和是否睑球粘
连四项指标的系统观察结果，对羊膜贴敷术的临床疗效作回
顾性总结，并分析影响临床疗效的相关因素。结果 术后平均
随访6个月（2-12个月），所有术眼均获得上皮化痊愈，无一
例发生角膜溃疡；10例12眼一次手术成功，5例8眼Ⅳ烧伤患者
一次术后残留部分上皮缺损，经再次手术完成上皮化。视力方
面14眼获得有用视力，其中达到0.1~0.4者10眼(50%)，≥0.5者
4眼(20%)；<0.1者仅6例6眼(30%)，均为严重的Ⅳ烧伤，手术使
患眼免于失明。导致视力低下的原因是角膜缘和瞳孔区角膜瘢
痕血管化，但手术为今后的增视性眼表移植术奠定了基础。
结论 对于重症眼表烧伤如能及时行羊膜贴敷术，可望取得比较
满意的治疗效果。总体疗效显示，受伤后越早接受手术，并于术
后坚持应用0.5%环孢素A滴眼，均能获得比较满意的疗效。羊膜
贴敷术能有效地促进上皮细胞的分化移行、抑制局部的炎症反应、
阻止新生血管和疤痕的形成、阻止烧伤的病理发展。本系列临床
观察提示，羊膜贴敷对重症眼表烧伤是一种比较理想的应急治疗
措施。
【关键词】 羊膜贴敷术；眼表烧伤；角膜上皮化; 环孢素A
Evaluation of curative effect of amniotic membrance patching
(AMP) for severe ocular surface burns Luo Qin, Zhu Zhizhong,
Zhu Li, Zhang Yanxia. Shanghai Peace Eye Hospital, Shanghai
200437,China
Corresponding author: Zhu Zhizhong, Email:zhuli@uninet.com.cn
【Abstract】 Objective To investigate and evaluate the
curative effect of amniotic membrance patching in severe ocular
surface burns and analyzing the factors of affect success of
surgery . Methods Fifteen cases (20 eyes) of AMP were performed
in patients with severe ocular surface burns, burns degree III-IV .
Their curative effect was analysed retrospectively according to
four norms of investigation: visual acuity after surgery, corneal
epithelialization, fibrovascularization in cornea ,and percentage
of symblepharon. Analyzing the factors to affect clinical effect .
Results Patients were followed up for 2 to 12 months (mean 7
months)after surgery. All the eyes obtaining epithelialization
and none corneal ulcer. The corneal surface of twelve eyes were
epithelized after once operation, eight eyes were epithelial rest
after performing AMP again. Visual acuity : (20%) of eyes ≥0.5,
50% of eyes ≥0.1 but ≤ 0.4, and 30% of them <0.1. Conclusions
Amniotic membrance patching is a reasonable surgery for severe
ocular surface burns because amniotic membrance can effectively
facilitate the polarization and migration of epithelium cell ,
reduce local inflammation reaction, neovascularization and fibrosis,
stopping the burned pathologic process.
【key words】 amniotic membrance patching; ocular surface burns;
corneal epithelialization; cyclosporin A
上海市科学技术委员会科研计划项目任务书，课题编号：034119683
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