三种手术方式治疗翼状胬肉的临床观察

目的 比较翼状胬肉单纯切除术、翼状胬肉切除术联合游离结膜瓣移植术及翼状胬肉切除术联合角膜缘干细胞移植术对翼状胬肉的治疗效果。 方法 将171例(186眼)翼状胬肉患者随机分为A、B、C3组,A组采用翼状胬肉单纯切除术,B组采用翼状胬肉切除联合游离结膜瓣移植术,C组采用翼状胬肉切除联合自体角膜缘干细胞移植术。比较各组间术后复发率、泪膜功能变化及术后并发症的发生率。 结果 A组的治愈率明显低于B、C组,且并发症发生率、修复时间及复发率均明显高于B、C组,差异具有统计学意义(P<0.05)。C组并发症发生率、复发率低于B组,修复时间和治愈率优于B组,具有显著性差异(P<0.05)。B、C组术后早期的泪膜稳定性优于A组,差异具有统计学意义(P<0.05)。 结论 与单纯翼状胬肉切除术和翼状胬肉切除联合游离结膜瓣移植术比较,翼状胬肉切除联合自体角膜缘干细胞移植术治疗翼状胬肉并发症少、复发率低,而且能够改善泪膜功能,是治疗翼状胬肉有效的手术方式。

Clinical observation on the effects of three surgical methods for pterygium

Objective To compare the therapeutic effects of simple pterygium excision, pterygium excision combined with free conjunctival flap transplantation and pterygium excision combined with autologous corneal limbus stem cell transplantation in the treatment of pterygium. Methods Totally 162 patients(186 eyes)were randomly divided into Group A, B and C. Group A were treated with simple pterygium excision, Group B with pterygium excision combined with free conjunctival flap transplantation, and Group C with pterygium excision combined with autologous corneal limbus stem cell transplantation. The recurrence rate, incidence of complications and change of tear function after surgeries were compared among the three groups. Result Group A was significantly lower than Group B and C in the cure rate, was higher than Group B and C in the incidence of complications and recurrence rate, and was longer than Group B and C in repair time(P<0.05). The incidence of complications, recurrence rate were lower and cure rate and repair time were better in Group C than those in Group B(P<0.05). The early postoperative tear films stability of Group B and C were better than that of Group A, with statistically significant difference(P<0.05). Conclusion Compared with single pterygium excision and pterygium excision combined with free conjunctival flap transplantation, pterygium excision combined with autologous corneal limbus stem cell transplantation is an effective method to treat pterygium,which can reduce the rate of complications, the recurrence,and improve tear function for patients with pterygium.