医用生物蛋白胶与缝线在翼状胬肉切除中应用的Meta分析  

Application of medical fibrin glue and stitch in pterygium excision: a Meta-analysis

作　　者：郭子君[1] 王微[1] 

机构地区：[1]中国医科大学附属盛京医院手术室,辽宁省沈阳市110004

出　　处：《中国组织工程研究》2015年第47期7703-7708,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:目前在翼状胬肉切除联合角膜缘上皮移植中,对于医用生物蛋白胶能否代替缝线固定自体球结膜植片还存在一定争议。目的:采用Meta分析比较医用生物蛋白胶与缝线在翼状胬肉切除联合角膜缘上皮移植中应用的效果。方法:查阅Pub Med数据库、CNKI全文数据库、中国生物医学文献数据库、维普数据库和万方数据库,从建库初始至2015年6月比较医用生物蛋白胶与缝线在翼状胬肉切除联合角膜缘上皮移植中应用效果的随机对照试验,采用Meta分析两组手术时间、术后并发症发生率及复发率。结果与结论:共纳入14篇随机对照试验,879例患者。Meta分析结果显示,纤维蛋白胶组手术时间、术后并发症发生率、术后6个月及1年的复发率均低于缝线组[MD=-15.58,95%CI(-18.96,-12.21),P<0.000 01;OR=0.39,95%CI(0.19,0.68),P=0.02;OR=0.28,95%CI(0.12,0.65),P=0.003];OR=0.23,95%CI(0.07,0.76),P=0.02]。表明翼状胬肉切除联合自体角膜缘干细胞移植中应用生物蛋白胶促进植片贴附,可缩短手术时间、降低术后并发症、减少翼状胬肉术后复发。BACKGROUND：Currently, in pterygium excision combined with limbal epithelial transplantation, there were stil some controversies about whether the medical fibrin glue could instead of stitch fixing autologous conjunctival graft. OBJECTIVE：To compare the therapeutic effect of medical fibrin glue and stitch in pterygium excision combined with limbal epithelial transplantation using Meta analysis. METHODS： The randomized controled trials about the therapeutic effect of medical fibrin glue versus stitch in pterygium excision combined with limbal epithelial transplantation were reviewed from PubMed database, CNKI ful-text database, Chinese Biomedical Literature Database, VIP database and Wanfang database from database creation to June 2015. The operative time, complications and recurrence rate of these two groups were analyzed using Meta. RESULTS AND CONCLUSION：A total of 14 randomized controled trials, and 879 patients were enroled. Meta-analysis results showed that the operative time, incidence of postoperative complications, the relapse rate after six months and one-year in the fibrin glue group were lower than those in the suture group [MD=-15.58, 95%CI （-18.96,-12.21）,P 〈 0.000 01]; [OR=0.39, 95%CI（0.19, 0.68）,P=0.02]; [OR=0.28, 95%CI（0.12, 0.65）,P=0.003]; [OR=0.23, 95%CI（0.07, 0.76）,P=0.02]. These results demonstrate that the application of fibrin glue in pterygium excision combined with limbal stem cel transplantation can promote graft attachment, shorten the operation time, reduce postoperative complications and reduce the postoperative recurrence of pterygium.

关 键 词：生物材料 材料相容性 医用生物蛋白胶 缝线 META分析 翼状胬肉 角膜缘上皮移植 

分 类 号：R318[医药卫生—生物医学工程]