不同手术移植方式联合胬肉切除治疗原发性翼状胬肉临床效果比较  

Comparison of clinical effects of different surgical transplantation methods combined with pterygium excision in the treatment of primary pterygium

作　　者：张键[1] 柏丽娜[1] 王晓莉[1] 蔡方荣 陈雍华 ZHANG Jian;BAI Lina;WANG Xiaoli;CAI Fangrong;CHEN Yonghua(Department of Ophthalmology,People′s Hospital of Jianyang City,Jianyang Hospital Affiliated to Southwest Medical University,Jianyang 641400,Sichuan Province,China;Department of Nursing,Southwest Hospital of the Army Medical University,Chongqing 400038,China)

机构地区：[1]简阳市人民医院/西南医科大学附属简阳医院眼科,四川简阳641400 [2]陆军军医大学西南医院护理部,重庆400038

出　　处：《新乡医学院学报》2022年第8期760-766,共7页Journal of Xinxiang Medical University

摘　　要：目的比较3种不同的手术移植方式联合胬肉切除治疗原发性翼状胬肉的临床效果。方法选择2017年12月至2020年12月简阳市人民医院收治的132例原发性翼状胬肉患者为研究对象,按手术移植方式将患者分为角膜缘干细胞移植组(n=44)、结膜瓣移植组(n=46)和羊膜移植组(n=42),角膜缘干细胞移植组患者给予胬肉切除联合角膜缘干细胞移植术治疗,结膜瓣移植组患者给予胬肉切除联合结膜瓣移植术治疗,羊膜移植组患者给予胬肉切除联合羊膜移植术治疗。观察记录3组患者术后眼部刺激症状消失时间、移植物愈合时间、术后6个月内并发症及胬肉复发情况。术前及术后6个月分别测定患者裸眼视力、屈光度、泪液分泌长度(SIt)、泪膜破裂时间(BUT)、角膜荧光素染色(CFS)评分、结膜杯状细胞数量、眼表疾病指数(OSDI)。结果角膜缘干细胞移植组和结膜瓣移植组患者术后眼部刺激症状消失时间、移植物愈合时间均显著短于羊膜移植组(P<0.05);角膜缘干细胞移植组与结膜瓣移植组患者的术后眼部刺激症状消失时间、移植物愈合时间比较差异无统计学意义(P﹥0.05)。3组患者术前裸眼视力、屈光度、SIt、BUT、OSDI评分、CFS评分、结膜杯状细胞数量比较差异无统计学意义(F=0.926、0.884、0.137、0.104、0.182、0.325、0.692,P>0.05)。术后6个月,3组患者的裸眼视力、SIt、BUT、结膜杯状细胞数量均较术前显著提高(P<0.05),屈光度、OSDI评分、CFS评分均较术前显著降低(P<0.05);术后6个月,角膜缘干细胞移植组、结膜瓣移植组患者的裸眼视力、SIt、BUT、结膜杯状细胞数量显著高于羊膜移植组(P<0.05),屈光度、OSDI评分、CFS评分显著低于羊膜移植组(P<0.05);术后6个月,角膜缘干细胞移植组与结膜瓣移植组患者的裸眼视力、屈光度、SIt、BUT、OSDI评分、CFS评分、结膜杯状细胞数量比较差异无统计学意义(P>0.05)。�Objective To compare the clinical effects of three different surgical transplantation methods combined with pterygium excision in the treatment of primary pterygium.Methods A total of 132 patients with primary pterygium admitted to Jianyang People′s Hospital from December 2017 to December 2020 were selected as the research objects,and the patients were divided into limbal stem cell transplantation group(n=44),conjunctival flap transplantation group(n=46)and amniotic membrane transplantation group(n=42)according to the surgical transplantation methods.The patients in the limbal stem cell transplantation group were treated with pterygium excision combined with limbal stem cell transplantation,the patients in the conjunctival flap transplantation group were treated with pterygium excision combined with conjunctival flap transplantation,and the patients in the amniotic membrane transplantation group were treated with pterygium excision combined with amniotic membrane transplantation.The disappearance time of ocular irritation symptoms,graft healing time,complications and pterygium recurrence within 6 months after operation were compared among the three groups.The naked eye vision,diopter,tear secretion length(SIt),tear film break-up time(BUT),corneal fluorescein staining(CFS)score,the number of conjunctival goblet cells,and ocular surface disease index(OSDI)were measured before and 6 months after operation.Results The disappearance time of ocular irritation symptoms and graft healing time of patients in the limbal stem cell transplantation group and conjunctival flap transplantation group were significantly shorter than those in the amniotic membrane transplantation group(P<0.05);there was no significant difference in the disappearance time of ocular irritation symptoms and graft healing time of patients between the limbal stem cell transplantation group and conjunctival flap transplantation group(P>0.05).There was no significant difference in the naked eye vision,diopter,SIt,BUT,OSDI score,CFS score and the number

关 键 词：翼状胬肉 角膜缘干细胞移植 结膜瓣移植 羊膜移植 

分 类 号：R772.2[医药卫生—眼科]