三重眼表解剖屏障重建术防治翼状胬肉复发四年前瞻性研究  

Prospective trial of ocular-surface reconstruction with three anatomic barriers to exterminate postoperative recurrence for primary pterygium

作　　者：范忠义[1] 蓝平[1] 周慧瑶 孟彤柏[1] 曲静涛[1] 李宝储[1] 

机构地区：[1]沈阳军区总医院眼科,110016 [2]沈阳市眼病研究所,110031

出　　处：《中国实用眼科杂志》2003年第4期249-251,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 :为解决翼状胬肉术后复发难题 ,在广泛性切除基础上 ,提出三重眼表解剖屏障重建的概念和方法 ,并对其防治翼状胬肉术后复发进行 4年前瞻性对照研究。方法 :初发性翼状胬肉 118眼随机分入A、B两组 ,A组 5 2眼单纯行翼状胬肉广泛性切除术 ,B组 66眼在此基础上联合行三重眼表解剖屏障重建术。根据Prabhasawat提出的术后分级方法 ,进行裂隙灯随访评定。 118眼随访时间均超过 4年 ,平均 5 9±3 60个月。结果 :经 4年以上随访A组 5 2眼取得根治性治愈者 42眼占 80 77% ,复发者 10眼占 19 2 3 % ,B组 66眼全部获得根治性治愈 ,复发率为零。两组间比较 ,χ2 检验P <0 0 0 1,差异有非常显著统计学意义。结论 :翼状胬肉广泛性切除联合三重眼表解剖屏障重建术对初发性翼状胬肉可达到一次手术彻底根治的目的 ,可推荐为治疗翼状胬肉的首选方法 ,翼状胬肉不宜早期手术的旧观念应该转变。Objective:To evaluate the new concept and surgical procedure reconstructing ocular-surface with three anatomic barriers,which was pointed out based on the expansive excision,in resolving the postoperative recurrence of primary pterygium. Methods:118 eyes of primary pterygia were randomly divided into A groups,only the new procedure of expansive excision performed (52 eyes);and B group,both the new procedure and the ocular-surface reconstruction of three anatomic barriers performed (66 eyes).The slit lamp was used to evaluate the results based on prabhasawat′ method.Follow up ranged from 4 to 6 years,averagely 59±3 6 months. Results:42 eyes (80 77%) in A group achieved the radical cure and the rest 10 eyes (19 23%) were recurrent.There was no case of recurrence in B group.The difference between the two groups was significant (χ 2-test,P<0 001). Conclusions:The surgical procedure for primary pterygium without recurrence can be achieved by combining the new expansive excision and the ocular-surface reconstruction of three anatomic barriers.It is valuable,at the present time,to recommend as the first choice for the management of primary pterygium.

关 键 词：三重眼表解剖屏障重建术 防治 翼状胬肉 复发 术后分级 

分 类 号：R777.33[医药卫生—眼科]