医用生物蛋白胶在翼状胬肉切除联合角膜缘干细胞移植术中的应用

Application of biomedical fibrin glue in pterygium excision combined with limbal stem cell transplantation

目的:探讨医用生物蛋白胶(biomedical fibrin glue,BFG)在翼状胬肉切除联合角膜缘干细胞移植术中应用的临床意义。方法:收集2009-06/2010-12我院门诊翼状胬肉患者59例60眼,分为两组,使用生物蛋白胶组34眼和未使用蛋白胶对照组26眼,均行翼状胬肉切除联合角膜缘干细胞移植术,观察手术时间、术后结膜植片贴附情况,球结膜充血以及患者不适症状。结果:生物蛋白胶组手术时间(13.6±3.5min)明显短于对照组(22.3±5.2min),术后2wk内(拆线前),生物蛋白胶组术眼疼痛、异物感和流泪等局部刺激症状均显著轻于对照组,两组术后均未发生植片移位并发症。生物蛋白胶组术后干细胞移植片贴附紧密,对照组有5眼(19%)植片贴附差,出现结膜后退,巩膜外露。生物蛋白胶组植片愈合良好,局部无明显结膜瘢痕形成;对照组均出现不同程度的缝线刺激性结膜瘢痕。术后6mo随访期内两组均未见翼状胬肉复发。结论:医用生物蛋白胶在翼状胬肉切除联合角膜缘干细胞移植手术中的应用可以缩短结膜伤口愈合的时间,促进角膜缘干细胞结膜植片贴附,使用中未见致敏反应的产生。

AIM：To estimate the therapeutic effects of pterygium excision combined with corneal limbal stem cells transplantation using biomedical fibrin glue in the treatment of pterygium.METHODS：In all the 59 cases（60 eyes）,group 1：34 eyes received pterygium resection＋limbal stem cell transplantation using biomedical fibrin glue.Group 2：26 eyes received pterygium resection＋limbal stem cell transplantation without biomedical fibrin glue.RESULTS：Group 1 needed shorter time in the surgery than the group 2.Meanwhile the patients who received pterygium resection＋limbal stem cell transplant using biomedical fibrin glue had less postoperative symptoms of stimulation.Limbal stem cell transplantation adhesion of 5 eyes（19%） was poor and sclera was exposed in group 2.Graft in fibrin glue group healed well,no significant local conjunctival scarring formed;the control group suffered from varying degrees of conjunctival scarring by suture irritation.After 6 months＇ follow-up,both groups had no pterygium recurrence.CONCLUSION：The patients who received pterygium resection＋limbal stem cell transplantation using biomedical fibrin glue have lower recurrent rate and less post-operative symptoms of stimulation.Using biomedical fibrin glue is an effective method to cope with pterygium.