自体角膜缘干细胞移植和自体游离球结膜移植治疗翼状胬肉的疗效观察  

Corneal limbal stem cells autograft and bulbar conjunctival autograft in pterygium excision

作　　者：吴晓红[1] 王文奇[2] 李赵霞[1] 尹忠贵[1] 

机构地区：[1]中国上海市浦东新区人民医院眼科,201200 [2]中国江苏省淮安市第一人民医院眼科,223300

出　　处：《国际眼科杂志》2004年第6期1147-1149,共3页International Eye Science

摘　　要：目的:比较翼状胬肉切除联合自体角膜缘干细胞移植术或自体球结膜移植术与单纯翼状胬切除术对初发性翼状胬肉的疗效。方法:将初发性翼状胬肉患者100例(105眼)随机分为3组,A组38例(38眼),行单纯翼状胬肉切除术;B组32例(33眼),行翼状胬肉切除+自体角膜缘干细胞移植术;C组30例(34眼),行翼状胬肉切除+自体游离球结膜移植术。术后随访12mo,观察3组患者翼状胬肉复发情况及B组和C组角膜创面上皮修复时间。结果:A组复发15眼,复发率为39.5%;B组复发1眼,复发率为3.0%;C组复发6眼,复发率为17.6%。复发率的比较:与A组相比,B、C组复发率降低,比较前者有非常显著性差异(P=0.00002);后者有显著性差异(P=0.04);B组和C组比较无显著性差异(P=0.0505)。角膜创面上皮修复时间B组为(3.48±0.83)d,C组为(5.29±0.87)d,B组快于C组,二者比较有非常显著性差异(F=75.33,P<0.0001)。结论:对初发性翼状胬肉,翼状胬肉切除联合自体角膜缘干细胞移植或联合自体游离球结膜移植均能有效降低其复发率,前者恢复角膜表型较后者更为优越。AIM: To compare the therapeutic effects of pterygium excision combined with c orneal limbal stem cells autograft or with bulbar conjunctival autograft and tho se of simple pterygium excision in the treatment of primary pterygium. · METHODS: A total of 100 patients (105 eyes) with primary pterygium were rando mly divided into three groups: Group A ( 38 eyes of 38 patients ) were performed with pterygium excision; Group B (33 eyes of 32 patients ) underwent pterygium excision with corneal limbal stem cells autograft; Group C (34 eyes of 30 patien ts ) underwent pterygium excision with bulbar conjunctival autograft. The post-o perative follow-up period was 12mo. Recurrence rate in each group was evaluated, and corneal epithelialization periods in Group B and C were compared. · RESULTS: The recurrence rates in the three groups were 39.5%, 3.0% and 7.6% r espectively. There were statistical differences between Group A and Group B(χ 2 = 13.44,P =0.0002<0.05) and between Group A and Group C (χ 2=4.14,P =0.04<0.05 ). There was no statistical difference between Group B and Group C (χ2= 3.82, P =0.0505>0.05). Corneal epithelialization period in Group B (3.48±0.83d) was sh orter than that in Group C (5.29±0.87d). There was a remarkable statistical dif ference between Group B and Group C (F =75.33,P < 0.0001). · CONCLUSION: Pterygium excision combined with corneal limbal stem cells autogr aft or with conjunctival autograft can result in the decrease of recurrence rate of primary pterygium, and the former was better than the latter in recovering t he corneal phenotype.

关 键 词：自体角膜缘干细胞移植 自体游离球结膜移植 治疗 翼状胬肉 疗效观察 

分 类 号：R779.6[医药卫生—眼科]