發(fā)布時(shí)間：2018-01-06 01:23

  本文關(guān)鍵詞：生物視膜抑制結(jié)膜纖維瘢痕形成的實(shí)驗(yàn)研究　出處：《眼科》2016年03期 　論文類型：期刊論文

  更多相關(guān)文章： 生物視膜 膠原纖維 結(jié)膜下瘢痕

【摘要】：目的觀察生物視膜對(duì)結(jié)膜纖維瘢痕形成的抑制作用。設(shè)計(jì)實(shí)驗(yàn)研究。研究對(duì)象新西蘭大白兔39只。方法 39只大白兔隨機(jī)分為三組,分別為生理鹽水組、絲裂霉素C(MMC)組、實(shí)驗(yàn)組,每組13只。用8 mm環(huán)鉆和維納斯剪制備右眼球結(jié)膜缺損的結(jié)膜損傷模型,左眼均不做處理。生理鹽水組傷口處放置10 mm的生理鹽水棉片2分鐘;MMC組傷口處放置10 mm的濃度為0.4 mg/ml的MMC棉片2分鐘。實(shí)驗(yàn)組將直徑10 mm、厚度2 mm的生物視膜放置在術(shù)區(qū)后復(fù)水,用無損傷10-0縫合線,將材料和傷口周圍的球結(jié)膜間斷縫合8針。術(shù)后7、14、28天觀察評(píng)估穹窿收縮率、傷口愈合率;術(shù)后7、14、28天取眼球做切片,應(yīng)用HE和MASSON染色,觀察浸潤(rùn)細(xì)胞種類和膠原纖維的疏密程度與排列。主要指標(biāo)穹窿收縮率、傷口愈合率、浸潤(rùn)細(xì)胞種類和膠原纖維的疏密程度與排列。結(jié)果 28天時(shí)生理鹽水組、MMC組、實(shí)驗(yàn)組的穹窿收縮率分別為45.1%±1.2%、25.5%±2.7%、23.6%±2.0%,實(shí)驗(yàn)組的穹窿收縮率明顯小于生理鹽水組(P0.001),實(shí)驗(yàn)組和MMC組差異無統(tǒng)計(jì)學(xué)意義(P0.05)。28天時(shí),實(shí)驗(yàn)組傷口愈合率為100%±0.0%,MMC組傷口愈合率為41.8%±2.0%,生理鹽水組為100%±0.0%,實(shí)驗(yàn)組和生理鹽水組之間差異無統(tǒng)計(jì)學(xué)意義(P0.05)。HE染色:術(shù)后28天時(shí),生理鹽水組有少量成纖維細(xì)胞,細(xì)胞周圍亦可見致密排列的膠原纖維,實(shí)驗(yàn)組則與正常結(jié)膜組織相似,MMC組浸潤(rùn)細(xì)胞數(shù)亦減少。MASSON染色:術(shù)后28天時(shí),生理鹽水組膠原纖維致密排列,實(shí)驗(yàn)組膠原纖維疏松未排列,MMC組膠原纖維疏松未排列。結(jié)論生物視膜對(duì)結(jié)膜纖維組織增生具有抑制作用,可防止結(jié)膜下瘢痕形成,抑制穹窿收縮,并能促進(jìn)傷口正常愈合,促使正常結(jié)膜下基質(zhì)形成。
[Abstract]:Objective To observe the inhibitory effect of bio membrane formation depending on conjunctival scar. The experimental research design. The research object of 39 New Zealand white rabbits. Methods 39 rabbits were randomly divided into three groups, respectively, the normal saline group, mitomycin C (MMC) group, the experimental group, 13 rats in each group. 8 mm trephine and Venus the shear damage model for the preparation of the right eye conjunctiva conjunctival defect in the left eye, do not handle. The saline cotton saline group wound placed 10 mM concentration for 2 minutes; group MMC wound placed 10 mm for 0.4 mg/ml MMC cotton for 2 minutes. The experimental group will be 10 mm diameter and 2 mm thickness of biological the membrane is placed in operation area after water, with no damage of 10-0 suture, the surrounding materials and wound suture needle 8. Conjunctival fornix 7,14,28 days after operation to evaluate the shrinkage rate, wound healing rate; postoperative 7,14,28 days from eyeball slice, using HE and MASSON staining to observe the infiltration of fine The degree of density and arrangement of cell types and collagen fibers. The main indicators of fornix shrinkage, wound healing rate, density and arrangement of infiltrating cell type and collagen fibers. Results the normal saline group, 28 days group MMC, experimental group were 45.1% dome shrinkage + 1.2%, 25.5% + 2.7%, 23.6% + 2%. The experimental group of the fornix shrinkage rate is less than the saline group (P0.001), there was no significant difference between the experimental group and MMC group (P0.05).28 days, the experimental group wound healing rate was 100% + 0%, MMC group wound healing rate was 41.8% + 2%, 0% + 100% in the saline group, there was no significant difference between the experimental group and saline group (P0.05):.HE staining 28 days after transplantation, the saline group has a small amount of fibroblasts, cells are visible around the dense arranged collagen fibers, experimental group and normal conjunctival tissue similar to that of MMC group also decreased.MASSON staining of infiltrating cells: 28 days after the operation, the saline group of dense collagen fibers arranged in the experimental group of collagen fiber loose arrangement, loose arrangement of collagen fibers in MMC group. Conclusion the biological membrane as has an inhibitory effect on the proliferation of fibrous tissue can prevent conjunctival and subconjunctival scar formation, inhibition of fornix contraction, and can promote wound healing, promote the formation of normal conjunctival stroma.

【作者單位】： 首都醫(yī)科大學(xué)附屬北京同仁醫(yī)院國(guó)家藥物臨床試驗(yàn)機(jī)構(gòu);首都醫(yī)科大學(xué)附屬北京同仁醫(yī)院北京同仁眼科中心北京市眼科研究所眼科學(xué)與視覺科學(xué)北京市重點(diǎn)實(shí)驗(yàn)室;
【基金】：“重大新藥創(chuàng)制”國(guó)家科技重大專項(xiàng)資助項(xiàng)目(2011ZX09302-007-05)
【分類號(hào)】：R77
【正文快照】： 結(jié)膜是眼球最前面的防御組織,且大部分暴露于外界環(huán)境中,易受鈍力、銳器、表淺異物、化學(xué)燒傷、輻射傷等而形成結(jié)膜損傷,結(jié)膜損傷愈合的最終結(jié)局是結(jié)膜瘢痕形成,結(jié)膜瘢痕的成因除上述因素造成的結(jié)膜損傷以外,自身免疫性疾病、感染、青光眼濾過術(shù)、斜視手術(shù)、翼狀胬肉等均可導(dǎo)

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