手术联合局部化学药物治疗眼表鳞状细胞瘤的临床效果  

Clinical efficacy of surgery combined with local chemotherapy for the treatment of ocular surface squamous neoplasia

作　　者：张丹娜 蔡佳玉 胡卫群 李锐[1] 喻静文 Zhang Danna;Cai Jiayu;Hu Weiqun;Li Rui;Yu Jingwen(Department of Ophthalmology,Xiaogan Central Hospital,Wuhan University of Science and Technology,Xiaogan 432100,China;Xiaogan Aier Eye Hospital,Xiaogan 432100,China;Graduate Training Base of Jinzhou Medical University,Jinzhou 121000,China)

机构地区：[1]武汉科技大学附属孝感中心医院眼科,孝感432100 [2]孝感爱尔眼科医院,孝感432100 [3]锦州医科大学研究生培养基地,锦州121000

出　　处：《中华眼外伤职业眼病杂志》2023年第2期99-106,共8页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：孝感市自然科学计划项目(XGKJ2021010033)。

摘　　要：目的探讨手术联合局部化学药物治疗眼表鳞状细胞瘤的临床效果。方法随机对照研究。选择2018年1月至2021年10月经孝感市中心医院病理诊断为眼表鳞状细胞瘤的42例(42只眼)为研究对象, 按随机数字表法分为试验组(23例)和对照组(19例), 两组均行眼表鳞状细胞瘤切除联合羊膜移植术, 试验组术后联合局部化疗。随访1年。观察比较术前、术后两组眼表疾病指数问卷调查(OSDI)、泪膜破裂时间(BUT)、泪液分泌试验(SIt)、角膜荧光素染色(FL)及病理分型、复发情况。结果两组OSDI评分、BUT、SIt、FL在术后3周差异有统计学意义(t=-9.86、7.67、-7.22、6.72, 均P<0.05), 两组各项指标在术前、术后2周、12周差异均无统计学意义(均P>0.05)。试验组术后3周OSDI评分、BUT、SIt、FL与术前相比差异有统计学意义(t=0.79、13.12、9.88、8.88, 均P<0.001), 试验组术后16周与术前相比差异无统计学意义(均P>0.05)。术后病理分型两组比较差异均无统计学意义(均P>0.05)。术后1年, 试验组无复发, 对照组复发率为36.84%(7/19)。结论肿瘤切除联合局部化疗治疗眼表鳞状细胞瘤可以明显减少OSSN的复发, 缩短局部化疗的时间, 虽然治疗早期对干眼有一定的影响, 但是可逆的。Objective To investigate the clinical efficacy of surgery combined with local chemotherapy on ocular surface squamous neoplasia(OSSN).Methods This was a random control study.A total of 42 eyes of 42 cases with OSSN from Jan.2018 to Oct.2021 in Xiaogan Central Hospital were included.They were divided into two groups based on random number table methods with 23 cases in each group.OSSN resection combined with amniotic membrane transplantation were performed in both groups,and the trial group received local chemotherapy after surgery.The follow-up time was 1 year.The ocular surface disease index questionnaire(OSDI),tear break-up test(BUT),Schirmer’sⅠtest(SIt),corneal fluorescence staining(FL),the postoperative pathological classification and the recurrence investigation at 1 year after surgery were observed and compared.Results At 3 weeks after surgery,the difference in OSDI,BUT,SIt and FL between the two groups were statistically significant(t=-9.86,7.67,-7.22,6.72;all P<0.05).There were no statistically significant differences in OSDI,BUT,SIt and FL between the two groups at 1 day before surgery,2 and 12 weeks after surgery(all P>0.05).And the difference of all the indexes were significant in the trial group before surgery and at 3 weeks after surgery(t=0.79,13.12,9.88,8.88;all P<0.001).But there was no significant differences in all indexes in the trial group before surgery and at 16 weeks after surgery(all P>0.05).There were no statistically significant differences in postoperative pathological classification between the two groups(all P>0.05).At 1 year after surgery,the recurrence rate was 36.84%(7/19)in the control group and none in the trial group.Conclusion Tumorectomy combined with local chemotherapy can significantly reduce the recurrence of OSSN and shorten the time of local chemotherapy.Although there is some effect on dry eye in the early stage,it is reversible.

关 键 词：眼肿瘤 眼外科手术 肿瘤 鳞状细胞 干扰素Α2B 

分 类 号：R739.7[医药卫生—肿瘤]