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目的 探讨眼部严重盐酸烧伤的早期救治和後积治疗,重点评价了碱性成纤维细胞生长因子和羊膜移植在盐酸烧伤中的应用价值和作用。方法 对22例44只眼(Ⅰ度烧伤11只眼,Ⅱ度烧伤15只眼,Ⅲ度烧伤12只眼,Ⅳ度烧伤6只眼)进行早期抢救後在预防感染的基础上,加用碱性成纤维细胞生长因子——贝复舒,3只眼施行了羊膜移植,其中1只眼联合了角膜干细胞的角膜移植治疗。结果 随访观察15个月,Ⅰ～Ⅱ度烧伤26只眼,视力恢复正常;Ⅲ度烧伤12只眼,视力在0.5以上:Ⅳ度烧伤6只眼,3只眼视力在0.2～0.3,2只眼视力在0.1～0.15,1只眼视力在0.04,这6只眼角膜有显著混浊和血管翳,但全部患者没有发生感染、角膜穿孔和睑球粘连。结论 严重盐酸烧伤经及时早期救治後,在综合治疗的基础上加用碱性成纤维细胞生长因子,能加速创面愈合,对特别严重患者,可通过羊膜移植改善眼表功能,防止睑球粘连和穿孔,减少新生血管形成。
Objective To investigate the early treatment and postemergence treatment of ocular severe hydrochloric acid burns and evaluate the value and role of basic fibroblast growth factor and amniotic membrane transplantation in the treatment of hydrochloric acid burns. Methods In 22 patients with 44 eyes (11 eyes with first degree burn, 15 eyes with second degree burn, 12 eyes with third degree burn, and 6 eyes with grade Ⅳ burn), 22 cases were treated with alkali Fibroblast growth factor - Beifu Shu, three eyes had amniotic membrane transplantation, of which one corneal stem cells combined corneal transplantation. Results All the patients were followed up for 15 months. There were 26 eyes with Ⅰ ~ Ⅱ degree burns and their visual acuity returned to normal. 12 eyes with Ⅲ degree burns had a visual acuity of 0.5 or more: 6 eyes with Ⅳ degree burns, 0.2 ~ 0.3 eyes with 2 eyes, Visual acuity in the 0.1 ~ 0.15,1 eye visual acuity of 0.04, the six corneas have significant opacity and angioedema, but all patients without infection, corneal perforation and symblepharon. Conclusion Severe hydrochloric acid burns after timely and early treatment, combined with basic fibroblast growth factor on the basis of comprehensive treatment, can accelerate the wound healing, for particularly serious patients, amniotic membrane transplantation can be improved ocular surface function to prevent symblepharon and Perforation, reduce neovascularization.