自体角膜缘干细胞及羊膜移植治疗假性胬肉  

Clinical observation of limbal stem cell transplantation combined with amniotic membrane transplantation in the treatment of pseudo-pterygium

作　　者：谭叶辉[1,2] 肖启国[1] 何湘珍[1] 李红[1] 邵毅[2,3] 何欢[1] 

机构地区：[1]南华大学附属第二医院眼科,湖南衡阳421001 [2]厦门大学眼科研究所及附属厦门眼科中心,福建厦门361001 [3]中山大学附属中山眼科中心,广东广州510060

出　　处：《眼外伤职业眼病杂志》2009年第11期869-872,共4页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

基　　金：湖南省卫生厅科研基金(B2006-119)

摘　　要：目的评价自体角膜缘干细胞移植联合羊膜移植治疗假性胬肉的临床应用及疗效。方法将145例(162眼)假性胬肉随机分成2组:A组75例(82眼)行假性胬肉切除自体角膜缘干细胞移植联合羊膜移植术;B组70例(80眼)行假性胬肉切除羊膜移植术。术后均随访6月以上。结果145例(162眼)术后随访时间平均(24.30±12.15)月。A组75例(82眼),术后随访时间平均(23.84±12.47)月,有5眼复发,复发率为6.10%;B组70例(80眼),术后随访时间平均(24.75±11.62)月,有14眼复发,复发率为17.50%。两组比较,复发率差异有统计学意义(2χ=5.085,P<0.05)。角膜创面上皮愈合时间自体干细胞移植联合羊膜移植组平均为(4.25±1.02)d;单纯羊膜移植组平均为(6.42±1.36)d,两组比较,角膜创面上皮愈合时间差异有统计学意义(μ=11.417,P<0.05)。全部病例均无感染、排斥、复视或眼球运动障碍等并发症。结论自体角膜缘干细胞移植联合羊膜移植术治疗假性胬肉复发率低,是一种较好的手术方法。Objective To evaluate the clinical application efficacy of limbal stem cell autograft transplantation combined with amniotic membrane transplantation （AMT） in pseudo-pterygium. Methods 145 cases （ 162 eyes） with pseudo-pterygium were randomly divided into two groups： pseudo-pterygium excision combined with limbal stem cell autograft transplantation combined with amniotic membrane transplantation group （ A group： 75 cases, 82 eyes） and pseudo-pterygium excision combined with amniotic membrane transplantation group （ B group ： 70 cases, 80 eyes）. All the patients were followed up longer than 6 months after operation. Re. suits 145 cases （ 162 eyes） were followed up from 6 to 36 months （average 24.30 ± 12.15 months）. A group（75 cases,82 eyes）, during post operative terms of follow-up （ average 23.84 ± 12.47 months） ,5（6.10% ） eyes were recurrent. As for B group （70 cases,80 eyes ） , with in follow-up period （ average 24.75 ± 11.62 months） ,14（ 17.50% ） recurrent cases were found. There was statistical significant difference between 2 groups （ P 〈 0.05 ）. The average epithelial recovering time of corneal wound was （4.25 ± 1.02） days in A group , and （ 6.42 ± 1.36） days in B group, the difference was significant （ P 〈 0.05 ）. In the term of follow-up, no infection, repulsion, diplopia or moving obstacle of eye-ball were found in all cases. Conclusion Limbal stem cells autograft transplantation combined with amniotic membrane transplantation can decrease the recurrent rate. It is an ideal method of pseudo-pterygium surgery and is worth spreading in clinic.

关 键 词：假性胬肉 角膜缘干细胞 羊膜 移植 

分 类 号：R779.6[医药卫生—眼科]