论文部分内容阅读
目的 观察结膜细胞外基质 (extracellularmatrix ,ECM)作为结膜组织的替代材料用于结膜成形的特点及临床疗效。方法 将 30只兔制作结膜缺损模型 ,并将其随机分为 3组 ,实验组兔结膜采用组织工程技术制备的结膜ECM行结膜移植修补术 ,对照Ⅰ组采用新鲜异体结膜移植 ,对照Ⅱ组采用深低温冷冻的异体结膜 ,以观察移植修补术后结膜成形的情况 ,并行镜下、免疫组化及淋巴细胞毒检查。同时将结膜ECM应用于 7例烧伤后睑球粘连患者 ,行结膜囊成形 +结膜ECM移植术 ,观察其疗效。结果 动物实验组 ,结膜ECM移植后 1周可见新生血管自移植片边缘长入 ,8周时外观已接近正常结膜 ,无免疫排斥反应 ;光镜下可见移植后 4周时的移植区上皮已接近正常结膜上皮 ;电镜下 ,术后 8周可见再生的结膜上皮细胞超微结构与正常结膜上皮细胞基本一致。对照Ⅰ组术后 2周时 ,移植片可见大量炎性细胞浸润。对照Ⅱ组术后 4周时 ,移植区仍有部分上皮未覆盖。 7例患者结膜ECM移植术后 1～ 2周可见新生血管长入植片 ;2个月时 ,结膜组织与正常球结膜组织相近。术后随访 9～ 2 6个月 ,平均 18 3个月 ,结膜ECM植片存活良好 ,睑球粘连明显改善 ,已形成穹隆部 ,移植区结膜基本恢复正常颜色。结论 结膜ECM为目前理想的结膜替代材料。
Objective To observe the characteristics and clinical efficacy of extracellular matrix (ECM) as an alternative material for conjunctival tissue for conjunctival. Methods Thirty rabbits were made into conjunctival defects model and randomly divided into three groups. Conjunctival conjunctiva of the rabbits in the experimental group were repaired by conjunctival transplantation with conjunctival ECM. The control group Ⅰ was treated with fresh conjunctival transplantation and the control group Ⅱ with Cryophageal conjunctival cryopreservation in order to observe the situation of conjunctival formation after graft repair, parallel microscopy, immunohistochemistry and lymphocyte cytotoxicity. At the same time, conjunctival ECM was applied to 7 cases of patients with symblepharon after burn injury underwent conjunctival sac formation and conjunctival ECM transplantation. The curative effect was observed. Results In the experimental group and the conjunctival ECM, one week after the transplanted conjunctival ECM, the edge of the new blood vessel was implanted from the edge of the graft. At 8 weeks, the appearance of the new blood vessel approached normal conjunctiva without immune rejection. Normal conjunctival epithelium; electron microscopy, 8 weeks after the regeneration of conjunctival epithelial cells ultrastructure and normal conjunctival epithelial cells are basically the same. Control group Ⅰ 2 weeks after operation, the graft showed a large number of inflammatory cell infiltration. Control group Ⅱ 4 weeks after surgery, the graft area is still part of the epithelium is not covered. In 7 patients, 1 ~ 2 weeks after conjunctival ECM transplantation, neovascularization was seen. At 2 months, the conjunctival tissue was similar to that of normal conjunctiva. The patients were followed up for 9 to 26 months, an average of 18 3 months. The conjunctival ECM graft survived well and the symblepharon improved significantly. The dome was formed, and the conjunctiva in the transplantation area returned to normal color. Conclusions Conjunctival ECM is the ideal conjunctiva replacement material.