目的：评估羊膜移植辅助重组人表皮生长因子(rhEGF)在角膜碱性烧伤治疗中的临床疗效。

方法：前瞻性、随机对照研究。纳入2022年11月至2024年11月期间在我院就诊的角膜碱性烧伤患者； 所有患者均完成急症处理后，采用随机数字表法分为联合治疗组和常规治疗组； 常规治疗组接受包含rhEGF的基础治疗，联合治疗组在此基础上接受辅助羊膜移植治疗。观察并比较两组的临床疗效、角膜上皮愈合时间、最佳矫正视力、VAS评分、角膜新生血管化面积、泪膜破裂时间、角膜混浊评分以及炎症因子水平(IL-6、hs-CRP、TNF-α)。

结果：本研究共纳入患者110例110眼，联合治疗组和常规治疗组各55例55眼。联合治疗组年龄46.82±10.38岁，男26例，女29例。常规治疗组年龄45.13±11.57岁，男31例，女24例。联合治疗组的总有效率为94.5%(52/55)，显著高于常规治疗组的81.8%(45/55，P<0.05)。联合治疗组的角膜上皮愈合时间显著短于常规治疗组(P<0.001)，治疗后4 wk疼痛程度VAS评分显著低于常规治疗组(P<0.001)； 联合治疗组的角膜新生血管化面积显著小于常规治疗组(P<0.001)，泪膜破裂时间显著长于常规治疗组(P<0.001)，角膜混浊评分显著低于常规治疗组(P<0.001)； 治疗后4 wk，联合治疗组的炎症因子水平均显著低于常规治疗组(均P<0.05)。

结论：羊膜移植辅助rhEGF在角膜碱性烧伤治疗中具有显著的临床优势，能够提高治疗效果，加速创面愈合，减轻疼痛，减少角膜新生血管化，延长泪膜破裂时间，减轻角膜混浊，并降低炎症因子水平。

METHODS:In the prospective, randomized controlled study, patients with corneal alkaline burns treated in the hospital were enrolled between November 2022 and November 2024. After emergency treatment, patients were divided into combined treatment group and routine treatment group by random number table method. The routine treatment group was given basic treatment(rhEGF), while combined treatment group additionally underwent adjuvant amniotic membrane transplantation. The clinical efficacy, healing time of corneal epithelium, best corrected visual acuity, VAS scores, corneal neovascularization area, break-up time, score of corneal opacity, and levels of inflammatory factors(IL-6, hs-CRP, TNF-α)in the two groups were observed and compared.

RESULTS:There were 110 patients(110 eyes)in this study, including 55 cases(55 eyes)in each group. The combination group had a mean age of 46.82±10.38 y, including 26 males and 29 females. The routine treatment group had a mean age of 45.13±11.57 y, with 31 males and 24 females. The total response rate of combined treatment group \〖94.5%(52/55)\〗 was significantly higher than that of routine treatment group \〖81.8%(45/55), P<0.05\〗. The healing time of corneal epithelium in combined treatment group was significantly shorter than that in routine treatment group(P<0.001), and VAS score for pain severity after treatment was significantly lower than that in routine treatment group(P<0.001). The corneal neovascularization area in combined treatment group was significantly smaller than that in routine treatment group(P<0.001), break-up time was significantly longer than that in routine treatment group(P<0.001),and score of corneal opacity was significantly lower than that in routine treatment group(P<0.001). After treatment, levels of inflammatory factors in combined treatment group were significantly lower than those in routine treatment group(all P<0.05).

CONCLUSION:Adjuvant amniotic membrane transplantation combined with rhEGF presents prominent clinical advantages in the treatment of alkaline corneal burns. It can enhance therapeutic efficacy, accelerate wound healing, relieve pain, reduce corneal neovascularization, prolong tear film break-up time, alleviate corneal opacification, and reduce the levels of inflammatory factors.