自体富血小板凝胶在眼表烧伤治疗中的应用

摘要

目的：观察自体富血小板凝胶治疗轻、中度眼表烧伤的疗效。方法选取该科收治的眼化学烧伤、热烧伤患者41例(54眼)为研究对象,按照数字随机法分为自体富血小板凝胶治疗组(APG组)和对照组,APG组19例(26眼),对照组22例(28眼)。对照组采用常规局部和全身药物治疗,APG组在此基础上加用自体富血小板凝胶外用滴眼。比较两组患者平均创面的愈合时间、角膜新生血管的发生率及视力恢复情况。结果对照组6眼(21.4%)出现感染,APG组1眼(3.8%)；对照组平均愈合时间为(24.7±6.5) d,APG 组平均愈合时间为(19.1±3.5) d,APG 组平均愈合时间、感染率显著低于对照组(P<0.05)。对照组3个月后各有1眼出现角膜斑翳和角膜云翳,6眼出现角膜新生血管；APG组未出现角膜斑翳和角膜云翳病例,2眼出现角膜新生血管。 APG组角膜新生血管发生率显著低于对照组(P<0.05)。 APG组和对照组治疗后视力均得到不同程度的恢复,两组比较无显著差异(P>0.05)。结论自体富血小板凝胶可缩短眼表修复时间,降低感染率和角膜新生血管发生率,不影响视力恢复,是轻、中度眼表烧伤治疗的新选择。%Objective To observe the clinical effect of autologous plate-rich gel ( APG) in the treatment of mild and moderate ocular chemical injury and chermal burns. Methods Forty-one patients(54 eyes) with ocular chemical injury and chermal burns were stud-ied,who were randomized into APG group and control group. The control group received regular topical and systemic medication while the APG group received APG outward treatment based on regular topical and systemic medication. Comparison was made in respects of healing time,corneal neovascularization and vision acuity between two groups. Results There were 6 eyes infection and 1 eye infection in control group(21. 4%) and APG group(3. 8%) respectively. The average healing time was (24. 7±6. 5)d and (19. 1±3. 5)d in control group and APG group respectively. The average healing time and infection rate in APG group were lower than control group( P<0. 05). During 3 months,there were 1 eye corneal macula,1 eye corneal nebula,6 eyes ocular neovascularization in control group while 2 eyes ocular neovascularization in APG group. The rates of ocular neovascularization between two groups had obvious differences( P<0. 05). But the vision recovery between two groups had no obvious differences(P>0. 05). Conclusions The application of APG in the treatment of mild and moderate ocular chemical injury and chermal burns could shorten healing time,decrease the rate of infection and ocular neovascularization,and had no impact on vision recovery.