两种移植术治疗复发性翼状胬肉疗效比较

目的比较分析带结膜瓣角膜缘干细胞移植术与生物羊膜移植术对复发性翼状胬肉的疗效,探讨这两种方法中哪一种更适合基层医院开展。方法将78例(78眼)复发性翼状胬肉随机分成A、B两组。A组39例(39眼)行用带结膜瓣角膜缘干细胞移植术;B组39例(39眼)行生物羊膜移植术。术后随访36个月。结果 A组4例(4眼)翼状胬肉再次复发,复发率为10.3%;B组6例(6眼)翼状胬肉再次复发,复发率为15.4%;两组术后复发率比较差异无统计学意义(P>0.05)。结论生物羊膜移植和带结膜瓣角膜缘干细胞移植是治疗复发性翼状胬肉两种较好的方法,具有方便、修复快,术后患者自觉症状轻,复发率低等优点。但带结膜瓣角膜缘干细胞来源于自体眼表组织故不发生免疫排斥反应,可取代病变组织修复眼表,且费用低廉,更适合基层医院开展。

Comparison of curative effects of two types of transplantation in treatment of recurrent pterygium

Objective To compare the curative effects of conjunctival flap limbal stem cell transplantation and biological amniotic membrane transplantation in the treatment of recurrent pterygium and explore which therapy is more suitable for the primary hospitals.Methods 78 patients(78 eyes) with recurrent pterygium were randomly divided into group A and group B.The 39 patients(39 eyes) of group A received conjunctival flap limbal stem cell transplantation and the 39 patients(39 eyes) of group B received biological amniotic membrane transplantation.All the patients were followed up for 36 months.Results In group A,4 patients(4 eyes) went through recurrent pterygium,with the recurrent rate of 10.3%.In group B,6 patients(6 eyes) went through recurrent pterygium,with the recurrent rate of 15.4%;the postoperative recurrent rates of the two groups were not significantly different(P > 0.05).Conclusion Conjunctival flap limbal stem cell transplantation and biological amniotic membrane transplantation are two good therapies in the treatment of recurrent pterygium for their advantages like convenience,fast recovery,mild postoperative subjective symptoms,low recurrent rate etc.However,conjunctival flap limbal stem cells come from autologous ocular surface tissue,thus it can avoid immune rejection and repair the ocular surface in place of diseased tissue,and it is inexpensive,so it is more suitable for the primary hospital.