改良纤维蛋白粘合剂在眼表翼状胬肉手术中的应用

目的:观察表皮生长因子(epidermal growth factor,EGF)与纤维蛋白封闭剂复合物代替常规的缝线,在眼表胬肉手术中的使用情况。方法:对60例78眼翼状胬肉患者,根据胬肉生长侵犯角膜缘的范围分成两组,A组为侵犯范围<1/2者,共28例34眼,B组为侵犯范围≥1/2者,共32例44眼,随机将以上两组每组分成两小组,即A1,A2,B1,B2组。A1,B1组使用常规缝线10-0可吸收尼龙线缝合,A2,B2组为采用表皮生长因子的改良生物粘合剂纤维蛋白粘合剂粘贴法,A组手术采用胬肉切除联合结膜瓣移植术,B组手术采用单纯切除胬肉。术后对四组的手术时间、疼痛感觉、复发率、眼表上皮愈合时间、并发症等指标进行比较分析。结果:手术时间:A1组与A2组以及B1与B2组间比较具有显著差异性(P<0.05)。疼痛评估:采用改良生物粘合剂粘贴法组患者较常规缝线组疼痛减少有显著差异性(P<0.05);术后4,6d观察角膜上皮愈合情况,粘贴法组患者较常规缝线组上皮愈合面积大,有显著差异性(P<0.05);术后6mo复发率比较采用改良生物粘合剂粘贴法组患者较常规缝线组复发率减少,但统计学无显著差异性(P>0.05)。结论:在翼状胬肉手术中,采用改良纤维蛋白封闭剂复合物代替常规的缝线,可减轻患者疼痛,减轻炎症反应,缩短手术时间,避免手术后缝线松解拆线的麻烦,提高手术质量,加快术后角膜上皮愈合,降低复发率。

Research on the improved fibrin adhesive in pterygium surgery

AIM: To observe the application of bioadhesive fibrin adhesive and epidermal growth factor( EGF)instead of the conventional sutures in the ocular pterygium surgery.

METHODS: Totally 78 eyes in 60 cases of pterygium patients were divided into 2 groups according to the limbal violations range. Group A for the range of less than 1/2, a total of 28 cases, 34 eyes; Group B was greater than or equal to the range of 1/2, with a total of 44 eyes in 32 cases; each group was randomly divided into two groups A1, A2, B1, B2, one using absorbable sutures, the other using the improved adhesive fibrin paste method. The operation time, post-operative pain sensation, recurrence rate, and the ocular surface epithelial healing time were compared between the four groups.

RESULTS: The operation time between the group A1 and A2, B1 and B2 had significant differences(P<0.05). There was significant difference of pain assessment between the suture group and the fibrin paste group, the paste group was less pain feeling(P<0.05). The corneal epithelial healing were observed after 4 days and 6 days operation time, there was significant difference(P<0.05)of epithelial healing area in the fibrin paste group compared with the suture group. The recurrence rate during 6 months after operation was reduced in fibrin paste group, but there was no significant difference(P>0.05).

CONCLUSION:Using fibrin sealant compound in the pterygium surgery can relieve pain in patients, reduce inflammation, shorten the operation time, avoid the trouble feeling of suture after surgery, accelerate corneal epithelial healing, and reduce the relapse rate.