人纤维蛋白胶在翼状胬肉切除联合新鲜羊膜移植术中的应用  

Clinical effect of pterygium excision combined with fresh amniotic membrane transplantation using human fibrin glue with sutureless

作　　者：张斌[1] 李威[1] 何伟[1] Bin Zhang;Wei Li;Wei He(He Eye Hospital, Shenyang 110034, Liaoning Province, China)

机构地区：[1]沈阳何氏眼科医院,中国辽宁省沈阳市110034

出　　处：《国际眼科杂志》2020年第10期1823-1826,共4页International Eye Science

摘　　要：目的:观察翼状胬切除联合新鲜羊膜移植术中应用人纤维蛋白胶的临床效果。方法:采用前瞻性对照病例研究,观察2018-03/10在我院接受翼状胬肉切除联合新鲜羊膜移植术的原发性翼状胬肉患者153例153眼(双眼患者只选择胬肉较大眼手术)。将患者随机分为试验组和对照组,试验组(人纤维蛋白胶组)78例78眼,对照组(缝线组)75例75眼。在切除胬肉组织后,试验组用人纤维蛋白胶固定羊膜植片,对照组用10-0尼龙缝线间断缝合固定羊膜植片,10d后拆线。记录患者具体手术时间,比较各组患者术后2h,1、3、5及10d(拆线前)的疼痛情况,并观察术后1a时复发率情况。结果:试验组手术时间(14.5±3.6min)短于对照组手术时间(18.3±4.2min)(P<0.05);两组患者术后2h,1、3、5及10d(拆线前)疼痛水平评分组间、时间、时间及组间有差异(F=39.939、419.026、28.410,均P<0.01)。各时间点试验组患者疼痛水平评分均低于对照组(P<0.05);各组内不同时间点的疼痛评分差异显著(P<0.01)。术后1a时两组患者复发率相近(P>0.05)。结论:在翼状胬肉切除联合新鲜羊膜移植术中使用人纤维蛋白胶,可以缩短手术时间,减轻术后疼痛,但不能明显降低胬肉术后的复发率。AIM:To evaluate the clinical effect of human fibrin glue in pterygium excision combined with fresh amniotic membrane transplantation and its clinical value.METHODS:This study was a prospective analysis of 153 pterygium excision patients(153 cases,153 eyes)from March 2018-October 2018.The patients were randomly and evenly divided into two groups:observation group(78 eyes)and control group(75 eyes).In fibrin glue group,patients(78 eyes)underwent pterygium excision,and the bare selera was covered with fresh amniotic membrane using fibrin glue for graft adherence,while in suture group,patients(75 eyes),the an amaiotic membrane grafts was attached to the selera using 10-0 nylon sutures after pterygium excision.Record the surgical time and the degree of pain after surgery were evaluated at 2h,1,3,5 and 10d(before sutures out)after surgery.RESULTS:Average surgical time(14.5±3.6)min in fibrin glue group was significantly less than suture group(18.3±4.2)min(P<0.05).The scores of 2h and 1,3,5 and 10d(before thread removal)pain levels were statistically significant(F=39.939,419.026,28.410,all P<0.01).After surgery,the degree of pain of treatment group was significantly decreased compared to control group,the difference was statistically significant(P<0.01).There were significant differences in pain scores at different time points in each group(P<0.01).There were no significant differences in the 2 groups comparing treatment outcomes of the recurrence rate at the end of 12-month follow-up(P>0.05).CONCLUSION:It not only significantly reduces the surgical time,but also minimizes postoperative discomfort when we use fibrin glue in pterygium excisions.But it cannot decrease the recurrence rate.

关 键 词：纤维蛋白胶 翼状胬肉 羊膜 疼痛 

分 类 号：R779.6[医药卫生—眼科]