摘要
目的探讨异体硬脑膜的临床应用价值。方法将经酒精处理的兔硬脑膜植入家兔上穹窿结膜下，行光镜、电镜组织学检查和免疫学观察。对上睑下垂３０只眼、眼窝凹陷３只眼、眼睑缺损４只眼及远内眦畸形１只眼患者采用异体硬脑膜行眼部修复，随访１．５～２．５年。结果组织学检查显示，植入后１周植片周围细胞浸润；２周植片边缘部出现新生胶原组织；２～３个月植片被自身结缔组织替代。免疫学检查，植入前后单向混合淋巴细胞培养，显示植入前与植入９６小时、１２０小时的刺激指数差异均有显著性（Ｐ＜０．０５），混合培养１４４小时植入前后差异无显著性，植入前混合培养９６、１４４小时的刺激指数差异均有显著性（Ｐ＜０．０５），但植入后差异无显著性。植入前后特异性杀伤活性比较差异有显著性。临床应用２４例（３８只眼），其中治愈２６只眼，显效９只眼，失败３只眼，其失败原因与血运不佳有关。结论采用异体硬脑膜植入矫正上睑下垂、修补眼睑缺损、替代内眦韧带、充填眼窝凹陷、排斥反应轻，疗效较佳。
ObjectiveToexploretheclinicalvalueoftheduramaterimplantationinocularplas-ticsurgeries.MethodsAlcoholpreservedhomologousduramaterwasimplantedintotheupperfornixundertheconjunctivaofrabbiteyeandlight,electronmicroscopichistologicalandimmunologi-calexami-nationsweremadefortheimplant.38eyesconsistingof30eyesofblepharoptosis,4eyesofblepharo-coloboma,3eyesofholowsocketand1eyeofteleepicanthusweretreatedbyhomologousdu-ramaterimplantation.ResultsInthefolow-upperiodsrangingfrom1.5to2.5years,26eyesinthetreatedeyeswerecured,9eyesweremarkedlyimproved,3eyesfailed.Histologicalfindingsshowedthatafter1weekofimplantationtherewascelinfiltrationaroundtheimplant,at2weeksnewcolage-noustissuedevelopedatthemarginoftheimplantand2-3monthsaftertransplantation,thegraftswerereplacedbythepatient′sownconnectivetissue.Thehistologicalexaminationof3failurecasesshowedthatthecauseofthefailurewasduetotheischemiaofhomograft.Theresultsofunidirec-tionalmixedlympho-cytecultureshowedthatthestimulationindexbeforeimplantationincompari-sonwiththatat96and120hoursafterimplantationhadstatisticalsignificantdiferences,whileincom-parisonwiththatat144hoursafterimplantationhadnosuchdiference.Beforetheimplantation,thestimulationindexofthelymphoeyteeultureat96hourswassignifieautlydiferentfromthatat144hoursstatisticaly(P<0.05).Inthecomparisonofspecifickilingactivitybeforeandafterim-plantation,therewasstatisticalsignificantdiference.ConclusionTheefectsoftransplantationofhomologousduramateremployedinocularplasticsurgeriesofblepharoptosis,blepharocoloboma,teleepicanthusandholowsocketarefairlygood.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
1996年第3期190-193,共4页
Chinese Journal of Ophthalmology
