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目的 观察生物视膜对结膜纤维瘢痕形成的抑制作用.设计 实验研究.研究对象 新西兰大白兔39只.方法 39只大白兔随机分为三组,分别为生理盐水组、丝裂霉素C(MMC)组、实验组,每组13只.用8mm环钻和维纳斯剪制备右眼球结膜缺损的结膜损伤模型,左眼均不做处理.生理盐水组伤口处放置10 mm的生理盐水棉片2分钟;MMC组伤口处放置10 mm的浓度为0.4 mg/ml的MMC棉片2分钟.实验组将直径10 mm、厚度2mm的生物视膜放置在术区后复水,用无损伤10-0缝合线,将材料和伤口周围的球结膜间断缝合8针.术后7、14、28天观察评估穹窿收缩率、伤口愈合率;术后7、14、28天取眼球做切片,应用HE和MASSON染色,观察浸润细胞种类和胶原纤维的疏密程度与排列.主要指标 穹窿收缩率、伤口愈合率、浸润细胞种类和胶原纤维的疏密程度与排列.结果 28天时生理盐水组、MMC组、实验组的穹窿收缩率分别为45.1％±1.2％、25.5％±2.7％、23.6％±2.0％,实验组的穹窿收缩率明显小于生理盐水组(P＜O.001),实验组和MMC组差异无统计学意义(P＞0.05).28天时,实验组伤口愈合率为100％±0.0％,MMC组伤口愈合率为41.8％±2.O％,生理盐水组为100％±0.0％,实验组和生理盐水组之间差异无统计学意义(P＞0.05).HE染色:术后28天时,生理盐水组有少量成纤维细胞,细胞周围亦可见致密排列的胶原纤维,实验组则与正常结膜组织相似,MMC组浸润细胞数亦减少.MASSON染色:术后28天时,生理盐水组胶原纤维致密排列,实验组胶原纤维疏松未排列,MMC组胶原纤维疏松未排列.结论 生物视膜对结膜纤维组织增生具有抑制作用,可防止结膜下瘢痕形成,抑制穹窿收缩,并能促进伤口正常愈合,促使正常结膜下基质形成.“,”Objective To observe the inhibition of conjunctival scar by biological membrane.Design Experimental study.Participants 39 New Zealand albino rabbits.Methods Rabbits were randomly divided into 3 groups,each group of 13:saline group,MMC group,and experimental group.A 8-mm trephine and Vannas scissors were used to produce lesions of the right bulbar conjunctiva to establish conjunctival injury model.Left eyes were not disposed.Saline group was placed 10 mm saline cotton for 2 minutes.MMC group was placed MMC cotton piece (size is 10 mm,concentration is 0.4 mg/ml) for 2 minutes.Experimental group was placed biological membrane (diameter is 10 mm and thickness is 2 mm),saline infiltration.The material and conjunctiva were sewed up around the wound using 10-0 atraumatic suture.Evaluate the fornix shrinkage rate,wound healing rate in different time after operation.HE staining was applied to observe and MASSON staining to assess degree of density and arrangement of collagen fibers at the 7,14,28 day after surgery.Main Outcome Measures Fornix shrinkage rate,wound healing rate,general cell types,and degree of density and arrangement of collagen fibers.Results At day 28,fornix shrinkage rate of saline group,MMC group,experimental group was 45.1％±1.2％,25.5％ ± ±2.7％,23.6％±2.0％.The fornix shrinkage rate of experimental group was obviously smaller than that of saline group (P＜0.001).There was no significant difference between experimental group and MMC group (P＞0.05).At day 28,The healing rate of experimental group,MMC group,saline group was 100％±0.0％,41.8％±2.0％,100％±0.0％.There was no significant difference between experimental group and saline group (P＞0.05).The healing rate of experimental group was significantly higher than that of MMC group (P＜0.001).HE staining:at day 28,a small amount of fibroblasts were visible in saline group.Dense arrangement of collagen fibers were also found around the cells.The experimental group was similar to normal conjunctival tissue.The number of infiltrating cells in the MMC group also decreased.MASSON staining:at day 28,collagen fibers were dense arrangment in saline group.Collagen fibers were loose,but not arranged in MMC group and experimental gruop.Conclusion Biological membrane has an inhibitory effect on the proliferation of conjunctival fibrous tissue.It can inhibit subconjunctival scarring and fornix contraction.It also can promote the wound healing normally and the formation of normal subconjunctival matrix.