原发性翼状胬肉行联合手术干预的临床体会

目的：观察原发性翼状胬肉行联合手术干预效果并探讨其临床应用价值。方法选取2011年11月～2014年12月收治的86例原发性翼状胬肉患者为研究对象，均为单眼患者，随机抽签均分为对照组和观察组，其中对照组43例行翼状胬肉切除术治疗，观察组在对照组基础上行联合自体角膜缘干细胞移植术治疗，观察两组术后角膜透明率、角膜云翳发生率、角膜斑翳发生率情况，并观察两组术前、术后1个月内膜破裂时间（ BUT ）、泪液分泌试验（ SIt实验）、角膜荧光染色检查（ FL），对两组进行比较。结果观察组术后角膜透明率93.02％较对照组高，角膜云翳发生率4.65％、角膜斑翳发生率2.33％均较对照组低，差异具有统计学意义（ P＜0.05）。术后两组BUT、SIt均较术前明显增大，FL均较术前明显减小，差异具有统计学意义（ P＜0.05）；术后观察组BUT（10.45±2.89）s、SIt（13.57±4.82）mm／5 min均较对照组增大显著，FL（0.41±0.01）分较对照组减小地显著，差异具有统计学意义（ P＜0.05）。结论原发性翼状胬肉行联合手术干预，能够提高术后角膜透明率、减小角膜云翳发生率及角膜斑翳发生率，在术后恢复角膜、泪膜、泪腺功能疗效显著，其在临床上的应用值得推广。

Clinical Experience of Combined Surgical Intervention for Primary Pterygium

Objective To observe the effects and clinical application value of combined surgical intervention for pri -mary pterygium.Methods 86 cases of patients with primary pterygium who were treated in our hospital between Novem -ber 2011 and December 2014 were selected as study subjects .All patients were monocular and were randomly divided in-to control group and observation group .43 cases in the control group were treated with excision of pterygium .Based on this, the observation group was treated with autologous corneal limbal stem cell transplantation .The rate of corneal trans-parency, incidence of corneal nebula and incidence of corneal macula in the two groups after surgery were observed .The time of intimal rupture (BUT), Schirmer I test (SIt test) and corneal fluorescence -labeled examination (FL) in the two groups were observed and compared before surgery and 1 month after surgery.Results The postoperative corneal transparent rate in the observation group (93.02%) was higher than that in the control group after surgery while the inci-dence rates of corneal nebula and corneal macula (4.65%, 2.33%) were lower than those in the control group ( P<0.05).BUT and SIt in the two groups after surgery were significantly higher than those before surgery while the results of FL were significantly lower than those before surgery (P<0.05);After surgery, BUT (10.45 ±2.89)s and SIt (13.57 ±4.82 ) mm/5 min in the observation group were significantly higher than those in the control group while FL ( 0.41 ± 0.01) was significantly lower than that in the control group (P<0.05).Conclusions To apply combined surgical in-tervention in primary pterygium can improve the postoperative corneal transparent rate , reduce the incidence rates of cor-neal nebula and corneal macula .It is good for the recovery of cornea , tear film and lacrimal gland function after surgery . It is worthy of clinical promotion .