角膜绷带镜用于巨大翼状胬肉切除术后的观察  

Efficiency of bandage soft contact lens on corneal recovery after giant pterygium excision

作　　者：张尧明[1] 韩少霞 何柳[1] 

机构地区：[1]中山大学中山眼科中心海南眼科医院(海南省眼科医院),海南省眼科学重点实验室,海口570311

出　　处：《第三军医大学学报》2016年第21期2371-2376,共6页Journal of Third Military Medical University

摘　　要：目的观察巨大翼状胬肉切除术后使用角膜绷带镜患者术后疼痛以及角膜上皮生长情况。方法选取2013年9月至2015年9月就诊本院行翼状胬肉切除+自体结膜瓣移植的巨大翼状胬肉患者67例67只眼,按随机数字表法分为观察组及对照组,经医院伦理委员会批准,受试对象签署知情同意书。观察组在手术结束时立即佩戴软性角膜绷带镜,对照组不使用角膜绷带镜。两组患者于手术当天以及术后第1、2天,术后1周填写VAS视觉模拟量表,于裂隙灯下观察患者角膜上皮化情况。结果观察组35例35只眼,对照组32例32只眼。观察组术后当天,术后第1、2天,术后1周VAS量表评分分别为5.17±1.81、2.54±1.38、1.46±1.24、0.14±0.35;对照组术后当天,术后第1、2天,术后1周VAS量表评分分别为9.12±1.34、5.28±1.30、2.97±1.80、0.18±0.39;除术后1周,其他观察点观察组疼痛程度均低于对照组(P<0.05)。观察组角膜上皮化时间为(52.80±9.74)h,对照组角膜上皮化时间为(69.00±19.03)h,二者差异有统计学意义(P<0.05)。结论巨大翼状胬肉切除术后佩戴角膜绷带镜可以有效减轻患者术后疼痛,并加速角膜上皮愈合。Objective To observe the pain and corneal recovery in the patients wearing contact lens for corneal bandage after giant pterygium excision. Methods A total of 67 patients（ 67 eyes） with giant pterygium treated in our center from September 2013 to September 2015 were enrolled in this study. All the patients received pterygium excision and conjunctival autografting, and then randomly divided into the experimental group（ soft contact lens group,n = 35） and control group（ n = 32） after signing an informed consent and being approved by the Hainan Eye Hospital Ethics Committee. The experimental group was wearing contact lens immediately at the end of surgery,but the control group was not. Visual analog scale（ VAS） was carried out on the day of operation,and in 1 and 2 d,and 1 week postoperatively,and slit lamp corneal microscopy was performed to observe corneal recovery. Results The VAS scores were 5. 17 ± 1. 81,2. 54 ± 1. 38,1. 46 ± 1. 24 and 0. 14 ± 0. 35 at day 1 and 2,and 1 week postoperatively respectively in the experimental group,and were 9. 12 ± 1. 34,5. 28 ± 1. 30,2. 97 ± 1. 80 and 0. 18 ± 0. 39 respectively in the control group. Except the score at 1 week,the scores were significant lower in the experimental group than the control（ P〈0. 05）. The mean corneal re-epithelization time was 52. 80 ± 9. 74 h in the experimental group,which was significant shorter than that in control group（ 69. 00 ± 19. 03 h,P〈0. 05）. Conclusion Contact lens for corneal bandage will reduce post-operative pain and enhance corneal re-epithelization in the patients after giant pterygium excision.

关 键 词：翼状胬肉 角膜绷带镜 角膜上皮化 

分 类 号：R618[医药卫生—外科学] R619[医药卫生—临床医学]