改良酒精浸泡剥离法行翼状胬肉切除术的临床疗效评价  

Observation of improved alcohol soaked peeling in pterygium surgery

作　　者：李克勤 杨怡 黄怀洁 方海晏 牛梅民 

机构地区：[1]顺德区桂洲医院,广东省佛山市528305

出　　处：《眼科新进展》2015年第5期453-455,共3页Recent Advances in Ophthalmology

基　　金：佛山市科技局基金项目(编号:2014AB001673)~~

摘　　要：目的评价应用改良酒精浸泡剥离法行翼状胬肉切除术的临床疗效。方法选择103例(103眼)翼状胬肉患者为研究对象,分为对照组41例(41眼)和改良组62例(62眼)。对照组患者行常规翼状胬肉切除加羊膜移植术;改良组患者先用体积分数20%酒精浸泡翼状胬肉头部,再行常规翼状胬肉切除加羊膜移植术。比较两组术后症状消失时间、上皮愈合时间、并发症和复发情况及其术前、术后泪膜破裂时间、角膜散光度数和总高阶像差。结果改良组的症状消失时间、上皮愈合时间分别为(1.14±0.67)d、(4.12±1.31)d;对照组分别为(1.82±0.91)d、(5.54±1.82)d。改良组症状消失时间、上皮愈合时间明显短于对照组,差异均有统计学意义(t=4.428、4.582,均为P<0.05)。改良组术后泪膜破裂时间为(9.82±0.41)s,对照组为(8.86±0.28)s,差异有统计学意义(t=10.074,P=0.000)。改良组术后角膜散光度数(-0.409±0.208)D明显低于对照组(-0.571±0.392)D,差异有统计学意义(t=2.728,P=0.008)。总高阶像差明显低于对照组,差异有统计学意义(P=0.029)。改良组复发率明显低于对照组(分别为4.84%、9.76%),差异有统计学意义(P<0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论改良酒精浸泡剥离法行翼状胬肉切除术可有效改善眼部症状,提高临床疗效,安全性高,复发率低。Objective To observe and analyze the effects of improved alcohol soaked peeling in pterygium surgery. Methods A total of 103 pterygium patients （ 103 eyes） were randomly divided into control group （41 eyes） and improved surgical group （62 eyes）. Control group were treated by conventional excision of pterygium and corne- al stem cell transplantation, and surgical group were soaked by 20% alcohol and treated by conventional excision of pterygium and anmiotic membrane transplantation. Symp- toms disappear time, epithelial healing time, postoperative complications, recurrence, tear film break-up time, corneal astigmatism and total higher-order aberrations were compared between two groups. Results The symptoms disappear time and epithelial healing time in improved surgical group were （1. 14 ± 0.67）days and （4. 12 ± 1.31 ） days,respectively,significantly shorter than those in control group （ 1.82 ± 0.91 ） days and （5.54 ±1.82） days （t =4. 428,4. 582;all P 〈0.05）. The postoperative tear film breakup time in improved surgical group was （ 9.82 ± 0.41 ） s, significantly longer than that in control group （8.86±0.28）s （ t = 10.074 ,P = 0. 000）. The postoperative corneal astigmatism in improved surgical group was （ - 0.409 ± 0.208 ） D ,which was lower than that in control group （ - 0.571 ±0.392） D （ t = 2.728, P = 0,008 ）. The total higher-orderaberrations in improved surgical group was significantly lower than that in control group （P = 0.029 ）. The recurrence rate in improved surgical group was significantly lower than that in control group （ 1.61% vs 2.12% ） （P 〈 0.05 ）. There was no sig- nificant difference in postoperative complications between two groups （P 〉 0.05）. Conclusion Improved alcohol soaked peeling in pterygium surgery can effectively improve the ocular symptoms and improve the clinical efficacy, which is safe with low recurrence rate.

关 键 词：翼状胬肉 酒精浸泡 胬肉切除术 

分 类 号：R777.33[医药卫生—眼科]