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目的 探讨兔肉体颌下腺游离移植术后的泪液分泌及重症眼干燥症的治疗效果。方法 摘除兔泪腺制成眼干燥症模型后,颌下腺移植组通过显微血管吻合技术将自体颌下腺游离移植于颞侧眶区,导管吻合于外下穹隆结膜,对照组不做其它处理。术后观察泪液分泌、眼表荧光素染色及虎红染色、结膜印迹细胞检查、光镜、电镜等检查。结果 移植成功组泪液分泌最持续增加,2月时基本稳定,角膜荧光素染色及虎红染色积分分别为2.3±2.26,1.76±1.72,有1只兔眼发生角膜溃疡,而眼干燥症模型对照组相应积分为7.5±1.65,5.3±1.49,有7只兔眼出现角膜溃疡,两组间的差异均有显著性(P<0.05)。组织病理检查见对照组的眼表组织有明显的炎症细胞浸润和结构破坏,而移植组的颌下腺则具有较正常的组织结构。结论 自体颌下腺游离移植能保持持续的分泌功能,有效阻止实验性重症眼干燥症的发生。
Objective To investigate the therapeutic effect of tear secretion and severe dry eye syndrome after rabbit ossification of the submandibular gland. Methods After removal of lacrimal gland of rabbits, the model of xerophthalmia was made. The submandibular gland transplantation group was transplanted into temporal orbital zone by microvascular anastomosis technique. The catheter was anastomosed to the outer inferior conjunctiva without any other treatment. Postoperative tear secretion, ocular surface fluorescein staining and tiger red staining, conjunctival blot cell examination, light microscopy, electron microscopy and other tests. Results In the successful transplantation group, lacrimal fluid secretion increased most consistently and remained stable in February. The scores of corneal fluorescein staining and tiger red staining were 2.3 ± 2.26 and 1.76 ± 1.72, respectively. One corneal ulcer occurred in rabbits and the control group The corresponding integral of the group was 7.5 ± 1.65 and 5.3 ± 1.49, corneal ulcer was found in 7 rabbit eyes, the difference between the two groups was significant (P <0.05). Histopathological examination of the ocular surface of the control group showed obvious inflammatory cell infiltration and structural damage, while the submandibular gland of the transplantation group had a more normal tissue structure. Conclusion The autologous submandibular gland transplantation can keep the continuous secretory function effectively prevent the occurrence of experimental severe xerophthalmia.