手术切除联合角膜缘干细胞移植治疗翼状胬肉的疗效观察  

Observation on the therapeutic effect of surgical excision combined with limbal stem cell transplantation on treatment of pterygium

作　　者：吴勤[1] 杨春林[1] 陆瑶瑶 曹冬蕾 WU Qin;YANG Chunlin;LU Yaoyao;CAO Donglei(Department of Ophthalmology,Qidong Hospital of TCM,Jiangsu 226200,China)

机构地区：[1]启东市中医院眼科,江苏226200

出　　处：《中国临床新医学》2024年第9期1026-1031,共6页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：南通市科技计划项目(编号:JCZ2022064)。

摘　　要：目的 观察手术切除联合角膜缘干细胞移植治疗翼状胬肉的疗效。方法 招募2020年1月至2022年12月启东市中医院收治的翼状胬肉患者180例,采用随机数字表法将其分为Ologen胶原基质植入组(接受手术切除联合Ologen胶原基质植入治疗,90例145眼)和角膜缘干细胞移植组(接受手术切除联合角膜缘干细胞移植治疗,90例147眼)。比较两组治疗后屈光状态、泪膜功能、舒适度情况、创面愈合时间、临床疗效及复发情况。结果 两组术后裸眼视力(UCVA)、泪膜破裂时间(BUT)呈上升趋势,角膜散光度(CA)呈下降趋势,两组变化幅度差异有统计学意义(P<0.05)。在术后6个月,Ologen胶原基质植入组UCVA、BUT低于角膜缘干细胞移植组,CA高于角膜缘干细胞移植组,差异有统计学意义(P<0.05)。术后6个月,在畏光流泪、异物感、眼痛、球结膜充血4个维度,角膜缘干细胞移植组的舒适度评分显著优于Ologen胶原基质植入组(P<0.05)。角膜缘干细胞移植组的创面愈合时间显著快于Ologen胶原基质植入组[(2.85±1.06)d vs (3.04±0.31)d;t=2.073,P=0.039]。角膜缘干细胞移植组的临床有效率显著高于Ologen胶原基质植入组(98.64%vs 93.10%;χ^(2)=5.678,P=0.017),术后6个月的复发率更低(0.00%vs 4.14%;χ^(2)=4.325,P=0.038)。结论 手术切除联合角膜缘干细胞移植治疗翼状胬肉的疗效优于手术切除联合Ologen胶原基质植入治疗,值得推荐。Objective To observe the therapeutic effect of surgical excision combined with limbal stem cell transplantation on treatment of pterygium.Methods A total of 180 patients with pterygium who were admitted to Qidong Hospital of TCM from January 2020 to December 2022 were recruited and divided into the Ologen collagen matrix implantation group(receiving surgical excision combined with Ologen collagen matrix implantation treatment,145 eyes,90 cases)and the limbal stem cell transplantation group(receiving surgical excision combined with limbal stem cell transplantation treatment,147 eyes,90 cases)by using random number table method.The postoperative refractive status,tear film function,comfort level,wound healing time,clinical efficacy and recurrence were compared between the two groups.Results After surgery,the uncorrected visual acuity(UCVA)and tear break-up time(BUT)showed an increasing trend in both groups,while corneal astigmatism(CA)showed a decreasing trend,and the differences in the changing amplitudes between the two groups were statistically significant(P<0.05).At 6 months after surgery,the UCVA and BUT of the Ologen collagen matrix implantation group were lower than those of the limbal stem cell transplantation group,and the CA of the Ologen collagen matrix implantation group was higher than that of the limbal stem cell transplantation group,and the differences were statistically significant between the two groups(P<0.05).At 6 months after surgery,the comfort scores of the limbal stem cell transplantation group were significantly better than those of the Ologen collagen matrix implantation group in four dimensions,including photophobic tears,foreign body sensation,eye pain and hyperemia of the bulbar conjunctiva(P<0.05).The wound healing time of the limbal stem cell transplantation group was significantly shorter than that of the Ologen collagen matrix implantation group[(2.85±1.06)d vs(3.04±0.31)d;t=2.073,P=0.039].The clinical efficacy rate of the limbal stem cell transplantation group was significantly h

关 键 词：Ologen胶原基质 角膜缘干细胞移植 翼状胬肉 屈光状态 翼状胬肉切除术 

分 类 号：R777[医药卫生—眼科]