自体角膜缘上皮移植、羊膜移植与常规术式治疗翼状胬肉复发率的比较  

Comparison of three kinds of operation for pterygium.

作　　者：王伟娟[1] 赫天耕[2] 史秀茹[2] 

机构地区：[1]天津市汉沽区医院眼科,天津300480 [2]天津医科大学总医院眼科,天津300020

出　　处：《眼外伤职业眼病杂志》2007年第11期881-884,共4页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的通过对3种不同手术方式治疗翼状胬肉的复发率的比较,评价它们的治疗效果、安全性和可行性。方法翼状胬肉84例(86眼),原发性74例(76眼),复发性10例(10眼)。将其随机分为3组,A组:翼状胬肉单纯切除术20例(20眼);B组:翼状胬肉切除加自体角膜缘上皮移植术37例(38眼);C组:翼状胬肉切除加保存羊膜移植术27例(28眼)。复发率的三组样本数据间比较采用x^2检验,两两比较采用精确计算概率法。结果A、B、C组3种手术治疗翼状胬肉复发率分别为30.00%、5.26%、7.14%。经统计分析,A与B、A与C复发率差别均有统计学意义(P<0.05)。而B与C (P=1.000)复发率差别无统计学意义。结论翼状胬肉切除加自体角膜缘上皮移植或保存羊膜移植可以降低复发率,缩短角膜上皮修复时间,是较有效的安全的治疗方法。Objective To compare the recurrent rates be- tween three operation methods for the treatment of both primary and recurrent pterygium. Methods 84 cases （86 eyes） with pterygi- um were randomly assigned into 3 groups and operated. 74 cases （76 eyes） were primary and 10 cases were recurrent pterygium, Simple pterygium excision （A group） were adopted in 20 cases of 17 patiems with primary pterygium and 3 patient with recurrent pte- rygium, Limbal autograft transplantation（LAT, B group） were per- formed in 37 cases （38 eyes） of 5 patients with recurrent pterygium and the others with primary pterygium, Human amniotic membrane transplantation （AMT, C group） were operated in 27 cases （28 eyes） of 2 patients with recurrent pterygium and 25 （26 eyes） patients with primary pterygium, The recurrent rates between three operation methods for the treatment of pterygium by chi-square test of SPSS for windows 11,5 statistics. Results The recurrent rates of the patients in group A,B,C were 30,00% ,5.26% ,7, 14% , respectively. A and B, A and C has statistical significance （P 〈 0. 05）, B and C have no statistical significance. Conclusions The recurrent rates in LAT and AMT group were lower than that of simple pterygium excision group and were effective, safe, worth being popularized and applied clinically method to treat pterygium. LAT recovered limbal cellular barrier function and reconstruct the ocular surface. Limbal stem cell is the ultimate source of corneal ep- ithelium and maintain the normal corneal functions regeneration in pterygium epithelium. AMT changed the stroma of limbal stem cell.

关 键 词：翼状胬肉 羊膜 角膜缘干细胞 

分 类 号：R779.6[医药卫生—眼科]