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[摘要]
目的:凹凸面生物羊膜移植术治疗上皮内上皮癌的疗效观察。
方法:针对我科临床诊治为上皮内上皮癌患者24例(24眼),均进行肿瘤病灶清除,随机选择其中12例对切除的结膜部分以及巩膜创面行凹凸生物羊膜覆盖,另外12例行普通羊膜覆盖,术后观察对比角膜伤口的上皮愈合程度,凹凸面生物羊膜的降解情况,术后肿瘤复发情况以及其他的并发症。切除的肿瘤均进行组织病理学检查。
结果:所有患者样本的病理结果均为上皮内上皮癌,术后5d内两组患者术区角结膜上皮已无荧光素钠着染,14d左右羊膜完全降解,两组患者角膜愈合时间无统计学意义,术后视力提高两组相比较无统计学意义,随访1a期间,凹凸面羊膜覆盖组较普通羊膜覆盖组复发率低。
结论:肿瘤切除联合凹凸面生物羊膜移植术是治疗上皮内上皮癌有效的手术方法。
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[Abstract]
AIM: To observe the curative effect of excision combined with concavity-convex amniotic membrane transplantation in the treatment of intraepithelial epithelioma.
METHODS:Totally 24 cases of intraepithelial neoplasia(24 eye)diagnosed in our department were studied. The tumors of 12 cases were removed and the wound were covered by the concavity-convex amniotic membrane in the conjunctiva and part of the resection, and other 12 were covered by the amniotic membrane. The effect of these two surgeries were assessed via observing the epithelial healing, degradation of biological amnion, tear break-up time, tumor recurrence and other complications. The resection of the tumor were analyzed histopathologically.
RESULTS: The pathological results of all the patients were epithelial carcinoma. There were 24 patients that diagnosed -intraepithelial epithelioma pathologically. The conjunctival epithelium healed rapidly and were completed in 5d after operation in both groups. The amniotic membrane was completely degraded in about 14d. Postoperative visual acuity improvement was not statistically significant in two groups. All patients were followed up for more than 1y. The recurrence rates were significantly lower in concavity-convex amniotic membrane group than that in amniotic membrane group.
CONCLUSION: Tumor resection combined with concavity-convex amniotic membrane transplantation is an effective operation method for the treatment of intraepithelial epithelioma.
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