翼状胬肉切除联合自体球结膜或干细胞移植疗效的Meta分析  

Meta-analysis of the efficacy of conjunctival autograft and limbal conjunctival autograft for pterygium

作　　者：宋奔昊 金倚如 蒋自培[1] Ben-Hao Song;Yi-Ru Jin;Zi-Pei Jiang(The First Affiliated Hospital of Wenzhou Medical University,the First Provincial Wenzhou Hospital of Zhejiang,Wenzhou 325000,Zhejiang Province,China;the Eye Hospital of Wenzhou Medical University,Zhejiang Eye Hospital,Wenzhou 325000,Zhejiang Province,China)

机构地区：[1]温州医科大学附属第一医院浙江省立温州第一医院,浙江省温州市325000 [2]温州医科大学附属眼视光医院浙江省眼科医院,浙江省温州市325000

出　　处：《国际眼科杂志》2022年第8期1323-1332,共10页International Eye Science

摘　　要：目的:探究翼状胬肉切除联合自体球结膜移植(CAG)或干细胞移植(LCAG)的疗效对比分析。方法:系统性检索美国国立图书馆医学文献检索系统(PubMed)、荷兰医学文摘数据库(EMBASE)、科克伦图书馆(The Cochrane Library)、美国临床试验注册中心(The US trial registry),从建库起至2021-09所有的文献。对复发率、角膜上皮愈合时间、基础泪液分泌试验(SⅠt)和泪膜破裂时间(BUT)进行分析。应用Review Manager 5.3进行统计学分析,计数资料以相对危险度(RR)、计量资料以标准化均数差(SMD)及其95%可信区间(CI)表示。结果:共计纳入15项研究,接受手术眼数共1 883眼,其中897眼行LCAG术,986眼行CAG术。在复发率方面,LCAG组显著低于CAG组(RR=0.33,95%CI:0.15~0.71,P=0.004);在角膜上皮愈合时间方面,LCAG组显著短于CAG组(SMD=-0.87,95%CI:-1.64~-0.11,P=0.02);在SⅠt方面,两组结果变化值相近(SMD=0.03,95%CI:-0.33~0.40,P=0.86);在BUT方面,LCAG组较CAG组显著延长(SMD=0.40,95%CI:0.09~0.70,P=0.01)。结论:翼状胬肉切除联合LCAG较CAG的术后复发率更低,角膜上皮愈合更快,泪膜稳定性更好。AIM: To compare the analysis of conjunctival autograft(CAG) or limbal conjunctival autograft(LCAG) for treating pterygium.METHODS: Systematic search of the National Library of America Medical Literature Search System(PubMed), the Excerpta Medica Database(EMBASE), the Cochrane Library and the US Clinical Trial Registry which all literatures established of the database from September 2021. The rate of recurrence, corneal epithelial healing time, the change in Schirmer Ⅰ test(SⅠt) and the change in tear break-up time(BUT) were analyzed. Statistical analysis was performed using Review Manager 5.3, count data were expressed as relative ratio(RR),measurement data were expressed as standardized mean difference(SMD) with 95%CI.RESULTS: There were 15 studies included with a total number of 1 883 surgical eyes, among them, there were 897 eyes experienced LCAG while 986 eyes underwent CAG. For the rate of recurrence, LCAG group was lower than CAG group(RR=0.33, 95%CI: 0.15-0.71, P=0.004). For corneal epithelial healing time, LCAG group seemed to behave better than CAG group(SMD=-0.87, 95%CI:-1.64 to-0.11, P = 0.02). No statistical significance was found for SⅠt(SMD = 0.03, 95% CI,-0.33-0.40, P=0.86) and as for BUT, LACG group showed longer times against CAG group(SMD=0.40, 95%CI: 0.09-0.70, P=0.01).CONCLUSIONS: Pterygium resection combined with LCAG was with lower recurrence rate, faster corneal epithelial healing and more stable tear film rather than CAG.

关 键 词：翼状胬肉 自体球结膜移植 干细胞移植 

分 类 号：R779.6[医药卫生—眼科]