氟美松冲眼液在雷公藤联合干细胞移植治疗翼状胬肉中的应用研究  

The Study of Different Concentrations of Dexamethasone Eyedrops in Treatment of Pterygium with Tripterygium Wilfordii Combined with Stem Cell Transplantation

作　　者：王清秀[1] 张来霞[1] 李艳[1] 张杰[1] 

机构地区：[1]潍坊医学院附属医院眼科,山东潍坊261031

出　　处：《潍坊医学院学报》2011年第3期197-200,共4页Acta Academiae Medicinae Weifang

摘　　要：目的 探讨不同浓度氟美松冲眼液在术前、术中及术后（即刻）进行结膜囊冲洗对自体角膜缘干细胞移植治疗翼状胬肉临床疗效的影响.方法 自体角膜缘干细胞移植治疗的翼状胬肉患者268例（306眼）,随机分为治疗组（地塞米松组,以5%,10%,15%浓度又分为A,B,C 3组）和对照组（生理盐水冲洗组）,手术前口服雷公藤,分别于术前、术中、术后（即刻）进行结膜囊冲洗,观察结膜囊冲洗前后局部细菌情况及患者手术眼畏光、流泪、疼痛、异物感等自觉症状和结膜充血、水肿、结膜移植片水肿、结膜创面修复情况.结果 两组冲洗前后细菌阳性率均显著下降（P〈0.01）;而各组间冲洗前、后细菌阳性率则无差异（P〉0.05）.手术后自觉症状、结膜充血、水肿体征发生率和结膜移植片水肿消退时间、结膜创面修复时间治疗组明显低于对照组（P〈0.05）.治疗组中B组和C组自觉症状、结膜移植片水肿消退时间、结膜创面修复时间均明显低于A组（P〈0.05）.所有患者术眼均未见植片感染和移植片脱落,对照组复发率明显高于治疗组（P〈0.05）.结论 氟美松冲眼液能够提高干细胞移植治疗翼状胬肉的疗效,减少复发率,增加患者舒适度,且以10%浓度左右最为理想.Objecctive To investigate the clinical effect of rinsing the conjunctival sac with different concentrations of dexamethasone eyedrops on ptelygium treated with tripterygium wilfordii combined with stem cell transplantation. Methods Two hundred and sixty eight patients （306 eyes） with tripterygium treated with triptergium wilfordii eombined with stem cell transplantation were randomly divided into the treatment group（ dexamethasnne blunt eyedrops grnup,which was then divided into A（5% ） ,B（ 10% ） and C（ 15% ） group and the control group（ saline blunt eyedrops group）. Each patient in the two groups took tripterygium wilfordii before surgery for 3 days, and their conjunctival sacs were flushed before, in, and after the surgery. Postoperative photophobia, tears, pain, fi）reign body sensation, checked cornea redalerting,swelling general signs,the visual acuity and slit lamp, corneal edema were observed. Results The incidence of photophobia, tears,pain, foreign body sensation, ete self-conscious symptom, cornea reddening, swelling general signs and self-conseious symptom recovery time and eonjunctival congestion,edema recovery time and corneal edema subsidise time and repairing and stenting plain time in treatment group obviously lowered than that of the control group （ P 〈 O. 05 ） after the surgery. The incidence of the above mentioned symptoms of group B and group C after treatment was significantly lowered than that of group A（ P 〈0.05） ,and the group B and group C was similar（ P 〉 O. 05）. Allpatients in the two groups had no intraoperative infections, imp｜ant ablation, rejection, increasing intraocular pressure, symblepharon and movement disorders. The reeurrenee rate in the control group was obviously higher than the treatment group after 6 to 12 months following-up （P 〈0.05 ）. The recurrence rate of group A was higher than the group B and C, but there was no siginifieance between group B and C. Conclusion Dexamethasone blunt eyedrops can improve clinical efficacy

关 键 词：氟美松 雷公藤 翼状胬肉 干细胞 

分 类 号：R771[医药卫生—眼科]