手术切除联合自体血清滴眼液治疗翼状胬肉的疗效观察

目的:探讨手术切除联合100%浓度自体血清滴眼液治疗翼状胬肉的疗效.方法:选取2015-03/2016-03在钟祥市人民医院眼科住院确诊的120例120眼翼状胬肉患者,将其随机分为对照组和试验组.全部患者术后结膜囊内涂妥布霉素地塞米松眼膏加压包扎患眼,次日采用妥布霉素地塞米松滴眼液滴眼,6次/d,2滴/次;对照组加用聚乙烯醇滴眼液,6次/d,2滴/次;试验组加用100%浓度的自体血清滴眼液滴眼,6次/d,2滴/次.两组滴眼液每周递减2次,均治疗3 wk.术后3 mo进行手术疗效评定.结果:两组患者手术前的一般情况、眼部症状体征评分和泪液分泌试验的比较无统计学差异(P>0.05).手术后两组患者的眼部症状体征评分、角膜上皮和/或基质缺损面积及修复时间、泪液分泌试验的比较有统计学差异(P<0.05).对照组患者术后3 mo的复发率是6.7%;试验组是3.3%,两组间比较差异有统计学意义(P<0.05).结论:翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术后辅助应用100%浓度的自体血清滴眼治疗胬肉术后创面的愈合、眼表的重建,取得了很好的疗效.

Curative effect of surgical resection combined with 100% concentration of autologous serum eye drops for pterygium

AIM:To investigate the curative effect of surgical resection combined with 100% concentration of autologous serum eye drops in the treatment of pterygium.

METHODS: Totally 120 cases of 120 eyes with pterygium from March 2015 to March 2016 in Zhongxiang People''s Hospital were randomly divided into the control group and the experimental group. All patients were treated with tobramycin and dexamethasone ophthalmic ointment bandaged eyes postoperatively, and the next day tobramycin and dexamethasone eye drop were used, 2 drops, 6 times per day. The control group was treated with polyvinyl alcohol eye drops, 2 drops, 6 times per day, but the test group were treated with autologous blood concentration of 100% concentration of autologous serum eye drops, 2 drops, 6 times per day. The two groups were treated for 3wk. The curative effect was evaluated after operation of 3mo.

RESULTS: The preoperative general condition, ocular symptoms and signs score and Schirmer test of the two groups was no significant different(P>0.05). But there were significant differences of the two groups on ocular symptoms and signs score, corneal epithelium and/or matrix defect area and repair time, Schirmer test after the operation(P<0.05). In control group, the recurrence rate was 6.7%. And the experimental group were 3.3%. There was significant difference between the two groups(P<0.05).

CONCLUSION:The application of 100% concentration of autologous serum eyedrops after pterygium resection combined with autologous limbal stem cell transplantation of conjunctival flap was better for wound healing and ocular surface reconstruction postoperatively, and it achieved good curative effect.