不同方法治疗翼状胬肉对术后的效果影响  

Effects of different treatment methods on postoperative indexes in patients with pterygium

作　　者：吴香丽[1] 谢赟[2] 陈建华[1] 赵慧英[1] 殷英霞[1] 刘彦[1] 陈冬军[1] WU Xiangli;XIE Yun;CHEN Jianhua(Beijing Geriatric Hospital,Beijing 100095,China)

机构地区：[1]北京老年医院,100095 [2]河北省疾病预防控制中心

出　　处：《河北医药》2018年第9期1323-1326,共4页Hebei Medical Journal

摘　　要：目的探讨传统刮除法和撕脱法治疗翼状胬肉头部,对术后复发率及干眼相关指标的影响。方法原发性翼状胬肉患者120例(120眼)随机分为传统刮除法治疗组(传统组)与撕脱法治疗组(撕脱组),每组60例(60眼)。2组患者均行翼状胬肉切除联合自体结膜移植术。处理附着于角膜的翼状胬肉头部时,传统组采用刮除法,撕脱组采用顺时针撕脱法,观察2组角膜及结膜伤口愈合情况及2组在术后15 d、1个月、6个月及12个月4个时间点的泪膜破裂时间(break-up time,BUT)和SchirmnerⅠ结果及2组术后复发率。结果撕脱组角膜伤口愈合时间短于传统组,差异有统计学意义(P<0.05);撕脱组结膜伤口愈合时间与传统组比较差异无统计学意义(P>0.05)。术后15 d、1个月及12个月撕脱组较传统组BUT时间长,差异有统计学意义(P<0.05);术后6个月撕脱组较传统组BUT相比差异无统计学意义(P>0.05)。术后15 d、1个月及12个月撕脱组较传统组SchirmnerⅠ长度增长,差异有统计学意义(P<0.05);术后6个月撕脱组较传统组SchirmnerⅠ相比无统计学意义(P>0.05)。术后15 d、1个月传统组和撕脱组均未出现复发;术后6个月传统组有6眼复发,复发率为10.00%,撕脱组有2眼复发,复发率为3.33%,但复发率差异无统计学意义(P>0.05);术后12个月传统组有16眼复发,复发率为26.67%,撕脱组有7眼复发,复发率为11.67%,复发率高于撕脱组,差异有统计学意义(P<0.05)。结论与传统法相比,撕脱法能够减轻翼状胬肉术后干眼症,降低术后复发率。Objective To investigate the effects of traditional curettage and avulsion method on postoperative recurrence rate and related parameters of dry eye in treatment of pterygium head.Methods A totl of 120 patients with primary pterygium(120 eyes)were randomly divided into traditional treatment group(n=60,60 eyes)and avulsion treatment group(n=60,60 eyes).All the patients were treated by pterygium excision combined with conjunctival autograft transplantation surgery.In treating pterygium head attached to the cornea,the patients in traditional treatment group were treated by curettage method,however,the patients in avulsion treatment group were treated by clockwise avulseing method.After treatment,the healing status of cornea and conjunctiva was observed for both groups,moreover,the tear film break-up time(BUT),SchirmnerⅠmeasurement results and the recurrence rates at 15d,1m,6m,12m after operation were observed and compared between two groups.Results The healing time of cornea in avulsion treatment group was significantly shorter than that in traditional treatment group(P<0.05),however,there was no significant difference in healing time of conjunctiva between the two groups(P>0.05).The BUT time at 15d,1m,12m after operation in avulsion treatment group was significantly longer than that in traditional treatment group(P<0.05),however,there was no significant difference in BUT at 6m after operation between the two groups(P>0.05).Moreover the SchirmnerⅠlength at 15d,1m,12m after operation in avulsion treatment group was significantly longer than that in traditional treatment group(P<0.05),however,there was no significant difference in SchirmnerⅠlength at 6m after operation between two groups(P>0.05).No relapse at 15d,1m after operation was observed in both groups,but 16 eyes in traditional treatment group had relapse at 12m after operation,with recurrent rate being 26.67%,however only 2 eyes in avulsion treatment group had relapse,with recurrent rate being 11.67%,and the recurrent rate in traditional treatment group

关 键 词：翼状胬肉 撕脱法 泪膜破裂时间 ScirmnerⅠ 复发率 

分 类 号：R777.33[医药卫生—眼科]