翼状胬肉改良自体结膜移植术后干眼症状及泪膜功能的研究

目的 探讨预防翼状胬肉手术后复发的有效手术方法.方法 选择2010年1月至2013年3月期间接受显微手术的符合标准68例（68眼）翼状胬肉患者,随机分为A、B两组,A组：34例（34眼）,行常规翼状胬肉切除术;B组34例（34眼）,行改良自体结膜瓣移植术,按规定的方法进行术后处理,术后2个月分别对两组患者进行干眼症状的问卷调查、基础泪液分泌试验（SIt）测定、泪膜破裂时间（BUT）、角膜荧光素染色（FL）、手术区域充血情况（简记为QYCX）的检查.结果 TBUT的平均值：A组为5.84±3.44 s,B组为10.05±3.33 s,两组差异有统计学意义（P＜0.05）;A组SIt的平均值为7.68±5.07 mm,B组的平均值为12.03±6.39 mm,两组差异有统计学意义（P＜0.05）.对A组与B组出现干眼症状及试验阳性表现的比率进行χ2检验,A组出现干眼症症状、TBUT、QYCX的阳性比率明显高于B组（P〈0.05）,FL、SIt阳性比率与B组相比无统计学差异（P＞0.05）.结论 改良自体结膜瓣移植术能有效恢复泪膜的稳定性,对翼状胬肉的复发起到一定的预防作用.

Study on the eye symptoms and tear film function of modified autologous conjunctival transplantation.

Objective To discuss the effective operation method for preventing the recurrence of pterygium after operation. Methods 68 eases （68 eyes） of pterygium from 2010 January to 2013 March in this hospital during microsurgical operation standard were included into this study. All these patients were randomly divided into A, B group. Group A： 34 eases （34 eyes）, underwent pterygium excision. B group of 34 ca ses （34 eyes）, underwent modified autologous conjunctival flap transplantation, was performed according to the provisions of the method. The symptoms of dry eye questionnaire, Schirmer test （Shirmer I test） test, tear break up time （BUT）, Angular Membrane fluoreseein staining （ FL）, operation of regional congestion （abbreviated as QYCX） examination were performed at 2 months after operation respectively in two groups of patients. Results The average value of tear break up time ： 5.84 ± 3.44 s in group A, 10.05 ± 3.33 s in group B. The difference was statis tically significant （ P 〈 0.05 ）. The average value of A group of basal tear secretion test was 7.68 ± 5.07 mm, the average value of B was 12.03 ± 6.39 ram. The difference was statistically significant （ P 〈 0. 05 ）. Conclusion Recurrence stability of modified autologous conjunctival flap transplantation can effectively restore the tear film on pterygium, which play a preventive role.