逆向方法联合丝裂霉素结膜瓣转移术治疗翼状胬肉

目的:探讨降低翼状胬肉复发的手术方法。方法:将95例110眼随机分成两组,A组55例63眼采取逆向方法分离翼状胬肉,术中应用丝裂霉素(MMC)及自体结膜瓣移植术,B组常规手术组40例47眼,其中男16例18眼,女24例29眼,年龄28～67(平均41.15)岁,观察两组复发率及角膜上皮愈合时间的情况。结果:随访6～12mo,A组复发率为3.2%;B组复发率为36.2%,复发率比较差异有统计学意义(χ2=9.57,P<0.01)。角膜创面上皮愈合时间:A组平均为4.6±1.2d,B组平均为8.1±0.9d,角膜创面上皮愈合时间两组差异有统计学意义(t=13.08,P<0.01)。结论:逆向方法联合MMC及自体结膜瓣转移术治疗翼状胬肉是一种取材方便,操作简单易学,术后角膜创面恢复快、透明、光滑、结膜平复、复发率低的优点,该方法疗效确切,是理想的手术方式,值得在基层医院推广。

Clinical observation on reverse method combined with mitomycin C and conjunctival flap transplantation in the treatment of pterygium

AIM:To investigate the surgical method to reduce the recurrence of pterygium·METHODS: Totally 95 cases(110 eyes) were randomly divided into two groups.A group of 55 cases(63 eyes) used reverse method to separate pterygium,combined with mitomycin C(MMC) and autologous conjunctival flap transplantation intraoperatively.B group of 40 cases(47eyes) used conventional surgery.Recurrence rates and corneal epithelial healing time were observed·RESULTS:Followed up for 6-12 months,A group recurrence rate was 3.2%;B group recurrence rate was 36.2%,the difference was statistically significant(χ2 =9.57,P<0.01).Corneal epithelial wound healing time:average 4.6±1.2 days in A group,average 8.1±0.9 days in B group,the difference between the two groups was statistically significant(t=13.08,P <0.01) CONCLUSION:Reverse method combined with MMC and autologous conjunctival flap transplantation in the treatment of pterygium is convenient in drawing material,easy to learn,and with the advantages of faster recovery of corneal wound,calm conjunctiva,low recurrence rate and definite effect,which is an ideal surgical way and worth promoting in primary hospitals.