三种手术方法预防翼状胬肉复发疗效分析  

Analysis of efficacy of different operations for preventing recrudescence of pteryium

作　　者：谢立科[1] 杨新怀[1] 黄勤[1] 覃旭方[1] 全蝉娟 伍玉冰[1] 黄少兰[1] 

机构地区：[1]广东省中山市小榄人民医院眼科中心,广东中山528415

出　　处：《右江医学》2004年第5期422-424,共3页Chinese Youjiang Medical Journal

摘　　要：目的　探讨预防翼状胬肉复发的手术方法。方法　将 115眼翼状胬肉随机分为三组 ,分别予不同手术方法治疗。A组 3 5眼行翼状胬肉切除巩膜暴露 +丝裂霉素C(MitomycinC ,以下简称MMC)棉片敷贴 ;B组 3 7眼行翼状胬肉切除 +角膜缘干细胞移植 ;C组 43眼予翼状胬肉切除 +角膜缘干细胞移植 +MMC。观察三组复发率 ,角膜上皮愈合时间及并发症发生情况。结果　随访 1～ 3年半 ,A组复发率 2 5 .71%,B组复发率 13 .5 1%,C组复发率为 0 ,C组显著低于A、B组 (P<0 .0 5 )。A组角膜上皮愈合天数为 6± 1.17d ,B组为 5± 0 .96d ,C组为 4± 0 .64d ,C组愈合时间显著快于A、B组 (P <0 .0 1)。A组 2例浅层巩膜融解 ,C组 1例浅层角膜融解 ,均在 1周内治愈 ,未见其他严重并发症。结论　翼状胬肉切除 +角膜缘干细胞移植 +MMC治疗翼状胬肉疗效确切 ,并发症少 ,复发率低 ,值得临床推广。Objective To evaluate the operations for preventing recrudescence of pterygium. Methods 115 eyes with pterygium were divided into 3 groups randomly. Pterygium was ablated by MMC, and sclera was exposed in group A (35 cases).Pterygium was ablated and limbal stem cells auto-graft transplantation was performed in group B (37 cases). Pteryium was ablated by MMC and limbal stem cells auto-graft transplantation was performed in group C (43 cases).Results The followed-up periods of post-operation ranged from12 to 42 months. The recrudescence rate was 25.71%, 8.10% in group A and group B, respectively. No recrudescence occurred in group C. Eyes'shallow sclera of 2 cases were smelted in group A and 1 eye's shallow cornea smelted on group C. All patients were cured within 1 week, and no other serious complications happened. Conclusion Technique of pterygium ablated by MMC and performed Limbal stem cells auto-graft transplantation was effective, which had less complications and lower recrudescence. So it is worth to generalize in clinical treatment.

关 键 词：翼状胬肉 复发率 切除 并发症 治疗 手术方法 角膜缘干细胞移植 融解 随机 推广 

分 类 号：R779.6[医药卫生—眼科]