纤维蛋白胶和缝线在翼状胬肉切除联合自体结膜移植手术中应用的Meta分析  

Application of fibrin glue versus suture in pterygium excision and conjunctival autograft transplantation: A meta analysis

作　　者：胡健[1] 贾亮[1] 王丽强[1] 黄一飞[1] 王瑛[1] 马天驹[1] 孟晓丽[1] 

机构地区：[1]解放军总医院眼科,北京100853

出　　处：《解放军医学院学报》2015年第9期923-927,共5页Academic Journal of Chinese PLA Medical School

基　　金：北京市自然基金面上项目(7142147)~~

摘　　要：目的采用Meta分析比较纤维蛋白胶和缝线在翼状胬肉切除联合自体结膜移植手术中的效果。方法应用搜索词"pterygium","fibrin glue"和"suture"在数据库Medline、EMBASE、Cocharne Central Register of Controlled Trials和Google Scholar Search进行检索,检索日期范围2000年1月1日-2014年12月31日。两位独立作者对文献进行筛选、评估,对符合要求的随机对照试验文献提取数据。主要观察指标为术后复发率、手术时间、术后并发症。结果最终有5篇文献,336眼纳入分析。术后3个月纤维蛋白胶组与缝线组的胬肉复发率分别为2.04%(1/49)和6.25%(3/48),差异无统计学意义(P=0.36);术后6个月纤维蛋白胶组与缝线组的胬肉复发率分别为4.19%(7/167)和11.24%(19/169),差异有统计学意义(P=0.02);术后12个月纤维蛋白胶组与缝线组的胬肉复发率分别为4.08%(6/147)和12.93%(19/147),差异有统计学意义(P=0.01)。纤维蛋白胶组手术时间少于缝线组(P=0.000)。两组总并发症发生率差异无统计学意义(P=0.09);植片固定相关并发症均发生于纤维蛋白胶组,处理后均痊愈;两组需要手术处理的并发症发生率差异无统计学意义(P=0.18)。结论在翼状胬肉切除联合自体结膜移植手术中,纤维蛋白胶较缝线复发率更低,手术耗时更少;纤维蛋白胶组植片固定相关并发症多于缝线组,但容易处理。Objective To observe the fibrin glue versus suture in pterygium excision and conjunctival autograft transplantation. Methods From January 1, 2000 to December 31, 2014, database including Medline, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar Search were searched with the keywords of ＂pterygium＂, ＂fibrin glue＂ and ＂suture＂. Data were extracted from randomized controlled trials（RCTs） that compared fibrin glue with suture in pterygium surgery with a minimum follow up for six months. Postoperative recurrence, surgical time, postoperative complications were analyzed by Revman 5.0 software. Results Five RCTs with 336 eyes were eligible in this meta-analysis. There was no significant difference between two groups in term of recurrence rate in postoperative 3 months（2.04% vs 6.25%, P=0.36）, while the recurrence rate showed significant differences between two groups in postoperative 6 months（4.19% vs 11.24%, P=0.02） and 12 months（4.08% vs 12.93%, P=0.01）. The fibrin glue group was less time-consuming in surgical time（P=0.000）, while no significant differences were found between two groups in term of postoperative total complications（P=0.09）. All graft-fixation-related complications occurred in the fibrin glue group were healed after observation or treatment. Conclusion Fibrin glue shows less recurrence, less surgical time consuming compared with suture in pterygium excision and conjunctival autograft transplantation.

关 键 词：翼状胬肉 纤维蛋白胶 缝线 结膜移植 META分析 

分 类 号：R777.33[医药卫生—眼科]