手术治疗原发性翼状胬肉的前瞻性随机对照研究

The prospective randomized controlled study of primary pterygium surgery

目的：观察两种方法治疗原发性翼状胬肉对角膜创面上皮修复及其复发率的影响。方法采用前瞻性对照研究方法，按数字表法将128例患者（128眼）随机分成对照组64例和观察组64例，两组患者均行翼状胬肉切除＋角膜缘干细胞移植术，观察组64例64眼术中加用0．2 mg／mL 丝裂霉素 C（MMC）辅助治疗。观察角膜创面上皮修复速度，随访6～12个月，平均8．5个月，观察两组术后胬肉的复发率。结果术后两组移植片平整，结膜瓣边缘愈合良好。对照组、观察组术后角膜上皮愈合时间分别为（2．13±0．37）d、（2．87±0．41）d，两组差异有统计学意义（t ＝4．91，P ＜0．01）；术后复发率分别6．25％、4．69％，两组差异无统计学意义（χ2＝0．48，P ＞0．05）。结论两种方法治疗翼状胬肉术后的复发率差异无统计学意义，但联合MMC 可导致角膜上皮愈合延迟。

Objective To study two different methods in treatment of primary pterygium surgery on corneal epithelial wound repair and the influence on the recurrence rate.Methods Used prospective controlled study,accord-ing to a number table 128 patients with 128 eyes were randomly divided into control group （64 cases）,and observation group （64 cases）.The two groups of patients underwent pterygium excision and limbal stem cell transplantation. The observation group （64 eyes）received 0.2 mg/mL mitomycin C of mitomycin -C（MMC）adjuvant therapy. Corneal epithelial wound repair speed was observed.The patients were followed up for 6 -12 months,average 8.5months,the recurrence rate of pterygium was observed in the two groups.Results The grafts were smooth,and the conjunctival flap healed well in the two groups.The postoperative corneal epithelial healing time of the control group and the observation group were （2.13 ±0.37）d,（2.87 ±0.41）d,there was statistically significant difference （t =4.91,P 〈0.01）;The postoperative recurrence rates were 6.25%,4.69% respectively,there was no statistically sig-nificant difference （χ2 =0.48,P 〉0.05）.Conclusion There was no difference in recurrence rate between two kinds of pterygium surgical method,but the combined MMC can cause corneal epithelial healing delay.