纤维蛋白胶联合角膜缘干细胞移植在翼状胬肉治疗中的应用  

Limbal stem cell transplantation with fibrin sealant in treatment of pterygium

作　　者：龚静文[1] 蒋劲[1] 

机构地区：[1]浙江省人民医院眼科,杭州310014

出　　处：《浙江医学》2015年第5期371-374,385,共5页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划(2011ZHB001)

摘　　要：目的评估纤维蛋白胶(fibrin glue,FG)联合角膜缘干细胞移植在翼状胬肉治疗中的效能及安全性。方法 将50例原发性鼻侧翼状胬肉患者根据胬肉侵犯角膜的面积配对分为两组,每组25例、25眼。切除胬肉后,取患眼颞上方球结膜瓣覆盖于巩膜裸露区,实验组25眼用FG固定植片,对照组25眼用10-0尼龙线固定植片。于术后第1、3、7、14天及1、2、6个月对患者进行随访,观察手术耗时、患者术后不适症状、复发率及并发症等指标。结果 FG组平均手术耗时明显短于缝线组(P<0.01)且其各项术后不适症状均较缝线组轻(均P<0.01)。至随访6个月时FG组无一例胬肉复发,缝线组复发1例,两组复发率及并发症发生率的差异均无统计学意义(均P>0.05)。结论在翼状胬肉切除联合角膜缘干细胞移植术中使用FG可替代手术缝线,该法在缩短手术时间的同时还可减轻患者术后症状,长期随访结果令人满意,值得在临床上推广。Objective To evaluate the efficacy and safety of fibrin sealant used for limbal stem cel transplantation in pa-tients undergoing pterygium surgery. Methods Fifty patients （50 eyes） with primary nasal pterygium underwent pterygium exci-sion with limbal stem cel transplantation. The patients were divided into two groups and each group contained 15 males and 20 females. Limbal stem cel s taken from superotemporal limbus were used to cover the bare sclera after pterygium excision. In one group the transplant was attached to the sclera with fibrin sealant （study group） and the other group with nylon 10- 0 sutures （control group）. The patients were fol owed up on d1, 3, 7 and14 then on months 1, 2 and 6. The main outcome measures includ-ed operating time, postoperative symptoms, graft success rate, recurrence rate and complications. Results The average oper-ating time was significantly shorter （P〈0.001） and postoperative symptoms were fewer in study group than those in control group. No recurrence was observed in study group and the recurrence rate was 4%（1/25） in control group after 6- month fol-low- up （χ2=1.020, P=0.312）. There was no significant difference between two groups in complications including transplant loss, transient transplant edema, transplant overlying, nasal conjunctival fibrosis and graft shrinkage （P＆gt;0.05）. Conclusion Results show that fibrin sealant can replace sutures for attaching conjunctival autograft in primary pterygium surgery with satisfactory safety and effectiveness.

关 键 词：纤维蛋白胶 缝线 翼状胬肉 角膜缘干细胞 

分 类 号：R779.6[医药卫生—眼科]