四种手术方法治疗翼状胬肉168眼

目的 探讨单纯翼状胬肉切除术、翼状胬肉切除联合丝裂霉素C、翼状胬肉切除联合带角膜缘的结膜瓣移植术、翼状胬肉切除联合羊膜移植术四种方法治疗胬肉的手术效果。方法 分析翼状胬肉患者158例(168眼)接受不同手术方式的手术效果。其中，A组（41眼）接受单纯翼状胬肉切除术，B组（42眼）接受单纯胬肉切除联合丝裂霉素C术，C组（44眼）接受翼状胬肉切除联合带角膜缘的结膜瓣移植术，D组（41眼）接受翼状胬肉切除联合羊膜移植术。术后随访 6～12个月。结果 A组复发率 17.1% ，B组复发率为9.5％，C组复发率4.5%，D组复发率为4.9% 。A组的复发率和其它三组比较差异有统计学意义 (P﹤0．05)；B、C组、B、D组、C、D组复发率的比较差异无统计学意义(P﹥0．05)。C组的并发症较其他三组的并发症少。 结论 翼状胬肉切除联合带角膜缘的结膜瓣移植术是目前值得推广的手术方式，具有经济实用、复发率低、角膜上皮愈合快、并发症少等优点。

Four surgical treatments of pterygium on 168 eyes

Objectiv eTo compare the therapeutic effects of simple pterygium excision, pterygium excision combined with mitomycin C, limbus corneae stem cell transplantation, or amniotic membrane transportation on pterygium. Methods 168 eyes of 158 patients were divided into four groups, i.e. groups A，B, C and D, in terms of applied treatments．41 eyes (group A)，42 eyes (group B), 44 eyes (group C) and 41 eyes ( group D) were treated with simple pterygium excision, pterygium excision combined with mitomycin C, limbus corneae stem cell transplantation, or amniotic membrane transportation, respectively．The patients were followed up from 6 months to one year．Results The recurrence rates of pterygium in groups A，B, C and D were 17.1%，9.5%, 4.5% and 4.9%，respectively．The difference between group A and the other three groups(B,C and D)was statistically significant (P<0．05)，whereas there was no statistical significance between group B &; C ，group B &; D and group C &; D. Group C had fewer complications than the other three groups. Conclusion Pterygium excision combined with limbus corneae stem cell transplantation is the preferable methods while it demonstrates better cost effectiveness, lowere recurrence rate, shorter corneal epithelial healing time and fewer complications.