纤维蛋白胶在翼状胬肉切除联合无缝线羊膜移植术中应用的临床观察  

Clinical Observation of Applying Fibrin Glue in the Pterygium Excisions with Sutureless Amniotic Membrane Transplantation

作　　者：邸新[1] 姚涛[1] 赵宇丹[1] 何伟[1] 

机构地区：[1]沈阳何氏眼科医院,110034

出　　处：《中国实用眼科杂志》2010年第5期484-488,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的 观察与探讨纤维蛋白胶在翼状胬肉切除联合羊膜移植术中应用的方式方法和临床效果.方法 筛选原发性翼状胬肉患者21人（26只眼）,行胬肉切除联合羊膜移植术.所有患者随机分为无缝线组及缝线组：无缝线组11人（13只眼）,术中将胬肉组织切除后,采用纤维蛋白胶黏合固定羊膜植片;缝线组10人（13只眼）,以10-0尼龙缝线间断缝合固定羊膜植片.术后随访6个月,记录手术时间、术后症状和体征.并应用SPSS统计软件对两组结果进行分析.结果 无缝线组手术时间（13.6±3.5）min明显短于缝线组（22.3±5.2）rain（P〈0.01）.术后2周内（拆线前）,无缝线组术眼疼痛、异物感和流泪等局部刺激症状均显著轻于缝线组（P〈0.01）.两组术后均未发生植片移位并发症.无缝线组术后羊膜植片贴附紧密,均于术后1周内迅速上皮化.缝线组术后有5只眼（38.5%）发生羊膜下积液,羊膜上皮化较无缝线组略迟,于术后8～ 10d完全上皮化.无缝线组羊膜愈合良好,局部无明显瘢痕发生;缝线组均出现不同程度的缝线刺激性瘢痕.术后6个月随访期内两组均未见胬肉复发.结论 在翼状胬肉切除联合羊膜移植术中使用纤维蛋白胶可替代手术缝线,使用方便,并明显缩短手术时间,减轻术后刺激症状,并利于羊膜愈合、减轻局部瘢痕,达到更好的美容目的 .Objective To observe and investigate the clinical efficacy of fibrin glue for attaching human amniotic membrane after primary pterygium excision. Methods Twenty-one patients （26 eyes） with primary pterygium underwent pterygium excision with amniotic membrane transplantation.Patients were randomized to two groups： fibrin glue group and suture group.In fibrin glue group, 11 patients （13 eyes） underwent pterygium excision, and the bare sclera was covered with an amniotic membrane using fibrin glue for graft adherence; while in suture group,10 patients （13 eyes）, after pterygium excision, the an amniotic membrane grafts was attached to the sclera using 10-0 nylon sutures. All surgeries were performed by the same doctor and surgical time was recorded.Patients were followed up for six months and ocular signs and symptoms were recorded.The results were analyzed by statistic software of SPSS.Results Average surgical time （13.6± 3.5 min） in fibrin glue group was significantly less than suture group （22.3± 5.2 min） （P 〈0.01 ）.In 2 weeks after surgery （before sutures out）, less regional symptoms, such as pain, foreign-body sensation, tearing were observed in the fibrin glue group （P 〈0.01 ）.There were no transplant losses or dislocations in both groups by the end of the follow-up.It was observed that human amniotic membrane was tightly attached to the scleral bed in fibrin glue group.Complete epithelialization occurred in fibrin glue group within one week, while that in suture group was delayed to 8-10 days. Effusion was found under amniotic membranes in 5 eyes of suture group. Grafts＇ healing in fibrin glue group was better and no regional scar observed, while scars were seen in suture group at different levels.No recurrence was observed in both groups at the end of 6-month follow-up.Canclu- sions Our results showed that fibrin glue can replace of sutures for attaching human amniotic membrane graft in primary pterygium surgery.It not only significantly reduces the surgical time, mi

关 键 词：纤维蛋白胶 羊膜 翼状胬肉 

分 类 号：R777.33[医药卫生—眼科]