不同部位自体结膜移植治疗翼状胬肉的疗效观察  

Effect of conjunctival autograft transplantation from different locations on pterygium

作　　者：程海利 荣瑜[1] Cheng HaiLi;Rong Yu(Department of Ophthalmology,the Frist People's Hospital of Anqing,Anhui 246000,China)

机构地区：[1]安徽省安庆市第一人民医院眼科

出　　处：《临床眼科杂志》2020年第1期72-74,共3页Journal of Clinical Ophthalmology

摘　　要：目的评估翼状胬肉切除联合下方自体结膜移植治疗原发性翼状胬肉的效果。方法对47例(56只眼)翼状胬肉患者,随机分为观察组和对照组。所有患者均接受标准的翼状胬肉切除手术。观察组23例(28只眼)行下方自体结膜移植术,对照组24例(28只眼)行上方自体结膜移植术。对患者随访6个月,在随访期间,对两组手术时间,术后疼痛水平、并发症,复发率进行记录比较。结果两组患者术后移植片均成活,无感染和睑球粘连情况发生。观察组发生移植瓣出血3只眼(10.71%),对照组4只眼(14.29%),肉芽增生观察组和对照组各1只眼(3.57%),予剪除后随访未再复发。手术时间:观察组为(32.18±4.9)min,对照组为(32.04±4.05)min,差异无统计学意义(P>0.05)。术后疼痛评分两组差异无统计学意义(P>0.05)。术后6个月,观察组2只眼复发(7.1%),对照组1只眼复发(5.4%),差异无统计学意义(P>0.05)。结论不同部位取材自体结膜对于手术时间、术后疼痛评分、并发症发生率、半年后复发率无明显差别。当无法或不希望使用上方结膜作为供体来源时,下方结膜移植是一种有用的技术。值得在高危青光眼患者中推广和应用。Objective To evaluate the effect of pterygium excision combined with inferior conjunctival autograft in the treatment of primary pterygium.Methods Forty-seven patients(56 eyes)with pterygium were randomly divided into the observation group and control group.All patients received standard pterygium excision.The 23 patients(28 eyes)in the observation group were treated with inferior conjunctival autograft,while the 24 patients(28 eyes)in the control group were treated with superior conjunctival autograft.The patients were followed up for 6 months.During the follow-up period,the operation time,postoperative pain level,complications and recurrence rate of the two groups were recorded and compared.Results The conjunctival grafts survived in both groups,and no infection or symblepharon was observed.Autograft hemorrhage occurred in 3 eyes(10.71%)in the observation group and 4 eyes(14.29%)in the control group.Proliferation of granulation tissue occurred in 1 eye(3.57%)in the observation group and 1 eye(3.57%)in the control group,and no recurrence was observed after resection of the granulation tissue during the follow-up.The operation time was 32.18±4.9 min in the observation group and 32.04±4.05 min in the control group,without significant difference(P>0.05).There was also no significant difference in postoperative pain score between the two groups(P>0.05).Six months after the operation,pterygium recurred in 2 eyes(7.1%)in the observation group and 1 eye(5.4%)in the control group,and the difference was not statistically significant(P>0.05).Conclusions Using conjunctival grafts from different locations results in no significant difference in operation time,postoperative pain score,complication rate or recurrence rate after six months.Inferior conjunctival autograft could be considered when superior conjunctival autograft is not possible or desirable,and inferior autograft is suitable and applicable for high risk glaucoma patients.

关 键 词：下方 自体球结膜 翼状胬肉 上方 自体结膜 

分 类 号：R779.6[医药卫生—眼科]