翼状胬肉切除术联合自体角膜缘干细胞移植术治疗翼状胬肉效果分析  

Analysis of the effect of pterygium excision combined with autologous limbal stem cell transplantation on patients with pterygium

作　　者：杨道锋 王应飞 李杰[2] YANG Daofeng;WANG Yingfei;LI Jie(Department of Ophthalmology,Yucheng County People's Hospital,Yucheng 476300,China;Department of Ophthalmology,Henan Provincial People's Hospital(Henan Provincial Eye Hospital))

机构地区：[1]虞城县人民医院眼科,河南虞城476300 [2]河南省人民医院(河南省立眼科医院)眼科

出　　处：《沈阳医学院学报》2025年第2期155-159,共5页Journal of Shenyang Medical College

基　　金：河南省医学科技攻关联合共建项目(No.LHGJ20205307)。

摘　　要：目的:探究翼状胬肉切除术(pterygium excision,PE)联合自体角膜缘干细胞移植术(autologous limbal stem cell transplantation,LSCT)在翼状胬肉治疗中的应用价值。方法:回顾性分析2021年2月至2023年2月虞城县人民医院收治的125例翼状胬肉患者的临床资料,根据手术方法分为2组,将58例行PE联合羊膜移植术治疗患者设为对照组,另67例行PE联合LSCT治疗患者设为观察组。比较2组手术相关指标、手术前后视力水平、角膜参数[角膜散光度数、角膜荧光素染色(FL)评分]、泪液分泌功能[泪膜破裂时间(BUT)、Schirmer试验]及术后并发症情况。结果:观察组手术时间、角膜创面愈合时间、充血水肿消退时间、拆线时间均短于对照组(P<0.01);术后7 d、1个月、3个月,观察组视力水平高于对照组(P<0.05);术后1个月、3个月,观察组角膜散光度数、FL评分低于对照组,BUT、Schirmer试验高于对照组(P<0.05);术后2组并发症总发生率比较差异无统计学意义(P>0.05)。结论:PE联合LSCT治疗翼状胬肉效果确切,可加快术后恢复进程,改善角膜形态及泪液分泌功能,提高视力水平,且能确保手术安全性。Objective:To explore the application value of pterygium excision(PE)combined with autologous limbal stem cell transplantation(LSCT)in the treatment of pterygium.Methods:The clinical data of 125 patients with pterygium admitted to Yucheng County People's Hospital from Feb 2021 to Feb 2023 were retrospectively analyzed.The patients were divided into two groups according to the surgical method,with 58 patients undergoing PE combined with amniotic membrane transplantation as the control group and 67 patients undergoing PE combined with LSCT as the observation group.The surgical-related indicators and postoperative complications were compared between the two groups,as well as the pre-and post-operative visual acuity,corneal parameters[corneal astigmatism,corneal fluorescein staining(FL)score],tear secretion function[tear film breakup time(BUT),Schirmer test].Results:The operation time,corneal wound healing time,regression time of hyperemia and edema,and suture removal time in the observation group were shorter than those in the control group(P<0.01).The visual acuity level in the observation group was higher than that in the control group at 7 days,1 month,and 3 months after surgery(P<0.05).The corneal astigmatism degree and FL score in the observation group were lower than those in the control group at 1 month and 3 months after surgery,while BUT and Schirmer test were higher than those in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups after surgery(P>0.05).Conclusion:The combined treatment of PE and LSCT for pterygium is effective,which can accelerate the recovery process after surgery,improve corneal morphology and tear secretion function,enhance visual acuity,and ensure surgical safety.

关 键 词：翼状胬肉 翼状胬肉切除术 自体角膜缘干细胞移植术 羊膜移植术 角膜散光度数 

分 类 号：R779.6[医药卫生—眼科]