翼状胬肉手术治疗不同术式的比较

A trial comparing different surgery for pterygium

目的 探讨采用三种不同的手术方法治疗原发性翼状胬肉的临床效果 ,寻找一种能减少翼状胬肉术后复发的新术式。方法 采用随机分组方法对 1 1 0例 (1 2 0只眼 )原发性翼状胬肉进行病例对照研究 ,A组 2 2例 (2 3只眼 )采用翼状胬肉单纯切除术 ,B组 32例 (33只眼 )采用翼状胬肉切除联合术中应用 MMC,C组 5 6例 (6 4只眼 )采用翼状胬肉切除联合自体角膜缘干细胞移植术 ,手术均在手术显微镜下进行 ,术后随访观察 3个月至 1年。结果 A组复发率为 4 3.75 % ,B组复发率为 1 6 .6 7% ,C组复发率为 6 .6 7%。统计学处理 ,P <0 .0 0 5 ,三组间差异有非常显著性意义。A组和 B组比较、A组和 C组比较差异均有非常显著性意义 ,B组和 C组比较 ,无统计学差异。结论 翼状胬肉切除联合自体角膜缘干细胞移植术是一种较好的手术方式 ,能有效降低翼状胬肉的术后复发率 。

Objective To find a new surgerical technique to reduce the recurrent rate for postoperative pterygium through comparing the three surgerical tretment modalities of primary pterygium.Methods A prospective clinical trial of 110 patients (120 eyes) wre randomly assigned to three groups.Group A included 23 eyes of 22 patients,simple pterygium resection.Group B had 33 eyes of 32 patients,pterygium resection with Mitomycin C.Group C consisted of 64 eyes of 56 patients,pterygium resection with limbal autograft transplantation (LAY).The surgery was operated under microscope.The time of follow up was from 3 month to 1 year.Results In group A,the recurrent rate was 43.75%;in group B,the recurrent rate was 16.67%;in group C,the recurrent rate was 6.67%.The recurrent rate in three groups was significant (P<0 005).The significant difference was obtained between group A and group B or between group A and group C.There was no difference between group B and group C.Conclusion Pterygium resection with LAT was the best surgery for primary pterygium.It deserved to be popularized for the new surgerical technique to reduce the postoperative recurrent rate effectively