自体角膜缘移植术治疗复发性翼状胬肉疗效观察

目的　观察自体角膜缘移植术治疗复发性翼状胬肉的疗效。方法　对 10例 (10眼 )复发性翼状胬肉患者施行患眼健侧带结膜的自体角膜缘移植术。结果　随访 6～ 12个月 ,10例患者角膜移植片均透明光滑 ,愈合良好 ,无一例复发。结论　自体角膜缘移植术治疗复发性翼状胬肉有效、安全、简便。     

自体带结膜瓣角膜缘干细胞移植联合羊膜移植治疗复发性翼状胬肉

目的:降低翼状胬肉术后复发率,减少术后并发症。方法:采用自体带结膜瓣的角膜缘干细胞移植联合羊膜移植治疗26例(26眼)复发性翼状胬肉患者。结果:在26眼中显效25眼,复发1眼,有效率为96%。结论:采用自体带结膜瓣角膜缘干细胞移植联合羊膜移植,可有效维持角膜上皮与结膜上皮之间的屏障途径,阻止结膜上皮长入和新生血管形成,并使结膜下成纤维增殖抑制,睑球粘连松解,从而降低翼状胬肉术后复发率,减少术后并发症。     

翼状胬肉角膜缘干细胞移植与羊膜移植的比较

目的　观察自体角膜缘干细胞移植与羊膜移植治疗翼状胬肉术后临床效果。方法　翼状胬肉 14 2例 (15 0眼 ) ,随机分为A、B两组。A组 92例 (98眼 )行胬肉切除联合自体角膜缘干细胞移植 ;B组 5 0例 (5 2眼 )行胬肉切除联合羊膜移植。观察术后患者自觉症状、角膜愈合情况、新生血管及胬肉组织增生。结果　翼状胬肉切除联合角膜缘干细胞移植较联合羊膜移植术后不适症状轻时间短 ,角膜创面愈合快。随访 1～ 2年角膜缘干细胞移植组胬肉复发 7眼 ,睑球粘连 1眼 ,羊膜移植组胬肉复发 7眼 ,其它并发症 3眼。结论　角膜缘干细胞移植及羊膜移植均有助于降低翼状胬肉术后复发率 ,是治疗翼状胬肉的良好术式。但两者相比较前者术式明显优于后者 ,是处理翼状胬肉最佳术式。     

鸦胆子联合角膜缘干细胞移植治疗翼状胬肉

目的 :探讨鸦胆子在翼状胬肉联合手术中的安全性和有效性。方法 :在 41只眼的角膜缘干细胞移植联合翼状胬肉切除术中 ,用鸦胆子仁糊状粉末剂搽抹在巩膜创面的表面上 ,过五分钟后 ,使用注射用水将鸦胆子仁粉末从抹过的巩膜创面上冲洗掉。结果 :41例 (41只眼 )随访期间无复发 ,未见副作用及并发症。结论 :以鸦胆子仁技术行翼状胬肉切除角膜缘干细胞移植联合手术安全有效 ;术中应用鸦胆子可防止术后复发。     

自体角膜缘上皮干细胞移植与单纯翼状胬肉切除术疗效比较

目的：观察翼状胬肉单纯切除术与翼状胬肉切除加自体角膜缘干细胞移植术的临床疗效。方法：将2006年3月～2010年6月78例（93眼）翼状胬肉患者随机分为翼状胬肉单纯切除术组（对照组）及翼状胬肉切除加自体角膜缘干细胞移植术组（治疗组）,比较其疗效。结果：采用翼状胬肉单纯切除术后患者复发率为13.3%,上皮修复时间为（5.83±0.84）d;而采用自体角膜缘干细胞移植后复发率仅为2.08%,上皮修复时间为（3.02±0.79）d,且两者相比,差异有统计学意义（P〈0.05）。结论：翼状胬肉切除加自体角膜缘干细胞移植术与翼状胬肉单纯切除术相比,可以有效地降低复发率,而且缩短角膜上皮修复时间,是治疗翼状胬肉较为理想有效的方法。     

低浓度丝裂霉素C联合自体游离角膜缘干细胞移植治疗原发性翼状胬肉的研究

目的观察低浓度丝裂霉素C（MMC）在自体游离角膜缘干细胞移植术治疗原发性翼状胬肉的临床疗效。方法140例行翼状胬肉切除的原发性翼状胬肉患者140只眼,随机分为3组。A组40例患者40只眼,翼状胬肉切除术中用0．2mg／mL的MMC 3min。B组50例患者50只眼,翼状胬肉切除术中采用自体游离角膜缘干细胞移植。C组50例患者50只眼翼状胬肉切除术中接受自体游离角膜缘干细胞移植联合应用0．2mg／mL MMC 1 min。随访13～62个月,术后观察3组的复发率和并发症。结果复发率：A组4例（10．0％）,B组3例（6．0％）,C组2例（4．0％）。A组与B、C组复发率比较差异有统计学意义（P〈0．05）、B与C组复发率差别无统计学意义（P〉0．05）。刨面上皮完全形成在术后14d内。并发症：结膜肉芽肿A组2例,B、C组无;巩膜软化溶解A组1例。未发现角膜穿孔、虹膜炎、青光眼等其他严重并发症。结论自体游离角膜缘干细胞移植联合术中应用低浓度MMC（0．02％1min）无明显降低原发性翼状胬肉复发作用。     

人工全髋关节置换治疗成人期股骨头骨骺滑脱症

目的探讨成人期股骨头骨骺滑脱症的人工全髋关节置换的方法和疗效。方法16例17髋股骨头骨骺滑脱症患者接受人工全髋关节置换,采用髋臼加深和自体植骨于髋臼内上后方10～3点钟位,以加深和下移髋臼,重建臼顶部和后柱后壁,正确安置各种类型假体。结果对16例17髋的股骨头骨骺滑脱患者平均随访5年10个月,植入骨愈合,关节功能采用Harris评分,优(>90分)13例14髋,良(80～90分)3例3髋,无尚可(70～79分)和差(<70分)的病例。术后3例出现并发症,均已治愈或改善。结论加深髋臼和自体骨植骨重建髋臼顶部和后柱,再行人工全髋关节置换,是治疗成人期股骨头骨骺滑脱症成功的关键。     

Mobilization of Philadelphia-negative peripheral blood progenitor cells with chemotherapy with rhuG-CSF in chronic myelogenous leukaemia patients with a poor response to interferon-alpha

The purpose of this cooperative study was to evaluate the quantity and quality of Ph¹-negative progenitor cells mobilized in the peripheral blood of patients with chronic myelogenous leukaemia soon after aplasia induced by chemotherapy. 32 patients ineligible for allografting who were cytogenetically refractory to interferon-alpha (IFN-α) were entered into this study. The chronic phase varied widely, with a median duration of 17 months (range 3–90 months). All patients were treated with intensive conventional chemotherapy regimens and recombinant human granulocyte colony-stimulating factor (rhuG-CSF, lenograstim). Peripheral blood progenitor cells (PBPC) were harvested by leukaphereses during early recovery from chemotherapy-induced aplasia. A total of 119 leukaphereses were performed. Median numbers of CD34⁺ cells and CFU-GM collected were 2.04 × 10⁶/kg and 2.9 × 10⁴/kg, respectively. There was a significant correlation between white cell count and number of CD34⁺ cells in the leukaphereses (P = 0.0001, r² = 0.41, n = 104). A strict correlation between the number of CD34⁺ cells and CFU-GM in the leukapheretic product (P = 0.0001, r² = 0.39, n = 110) was observed. 21% of evaluable patients (6/29) achieved a complete cytogenetic remission in the leukapheretic product and the other four patients achieved a major cytogenetic response for an overall response of 35% (10/22 patients). To date, 16 patients have been autografted and are alive. Five of them are Ph¹-negative (three patients) or partially Ph¹-negative (two patients). In conclusion, despite the high-risk characteristics of this study population, Ph¹-negative PBPC were successfully mobilized in more than one-quarter of patients using a chemotherapy plus rhuG-CSF regimen. The importance of this achievement is increased by the current lack of other practical methods of rescuing Ph¹-negative cells in such patients.