手术切除联合角膜缘干细胞移植、羊膜移植及单纯手术切除治疗翼状胬肉临床疗效分析

Comparative analysis of surgical excision combined with limbal stem cell transplantation,amniotic membrane transplantation and surgery alone for the treatment of pterygium

目的探讨手术切除联合角膜缘干细胞移植、羊膜移植及单纯手术切除治疗翼状胬肉的临床疗效。方法选择本院2008年3月至2010年5月收治的角膜缘翼状胬肉患者90例,随机分为三组,角膜移植组给予手术切除联合角膜缘干细胞移植,羊膜移植组给予手术切除胬肉联合羊膜移植治疗,单纯手术组仅给予翼状胬肉手术切除;观察三组治疗效果。结果三组术后随访两年,角膜移植组、单纯手术组术后创面愈合时间短于羊膜移植组,差异有统计学意义(P<0.05),角膜移植组创面愈合时间与单纯手术组差异无统计学意义(P>0.05);角膜移植组术后治愈28例,复发2例,羊膜移植组术后治愈25例,复发5例,单纯手术组术后治愈22例,复发8例,三组术后复发率比较,差异有统计学意义(P<0.05)。结论手术切除联合角膜缘干细胞移植治疗翼状胬肉,术后复发率低,并发症少,愈合时间短,值得应用。

Objective o evaluate the clinical efficacy of surgical excision combined with limbal stem cell transplantation,amniotic membrane transplantation and surgery alone for the treatment of pterygium.Methods 90 pterygium patients from March 2006 to May 2010 were randomly divided into corneal transplantation group,amniotic membrane transplantation group,surgery group,with 30 cases each group.Corneal transplantation group were treated with surgical excision plus limbal stem cell transplantation,amniotic membrane transplantation group were treated with surgical excision plus amniotic membrane transplantation,and surgery group with surgical excision only.The treatment effects of three groups were observed.Results All the patients in three groups had been followed up for 2 years;wound healing time of corneal transplantation group and surgery group was shorter than that of amniotic membrane transplantation group,with the statistically significant difference（P〈0.05）,and difference of wound healing time between corneal transplantation group and surgery group was not statistically significant;28 cases of corneal transplantation group were cured,and recurrence in 2 cases;25 cases of amniotic membrane transplantation group were cured,and recurrence in 5 cases;22 cases of surgery group were cured,and recurrence in 8 cases,and the difference of recurrence rate of three groups was statistically significant（P〈0.05）.Conclusion Surgical excision combined with limbal stem cell transplantation can treat pterygium,with low recurrence rate,fewer complications,short healing time.