海水盐场职工翼状胬肉患病率分析及手术治疗的临床观察

Prevalence of pterygiurn in seawater saltern and clinical observation on operation treatment of pterygium

目的了解翼状胬肉在江苏省海水盐场45岁以上职工中的分布特点，评价年龄、性别、职业环境等因素与翼状胬肉发生的关系，及自体角膜缘干细胞移植术治疗翼状胬肉的临床疗效。方法在江苏省金桥盐化集团六大盐场45岁以上职工中随机整群抽取12062人（24124眼）作为研究对象，统计翼状胬肉的患病率，76例（83眼）接受自体角膜缘干细胞移植术，随访10～24个月评价手术效果。结果45岁及以上职工翼状胬肉总患病率为5．645％，男性患病率为5．484％，女性患病率为5．787％，男性和女性患病率差异没有统计学意义（P〉0．05），45～54岁年龄组低于55—64岁年龄组，差异有统计学意义（P〈0．05），55～64岁年龄组与65岁以上年龄组患病率差异无统计学意义（P〉0．05）。76例（83眼）行自体角膜缘干细胞移植术后复发3眼，复发率3．614％。结论翼状胬肉患病率较高与该地区地理位置、工作性质、年龄及经济条件等有关。重建角膜缘干细胞活性是翼状胬肉治疗的关键，自体角膜缘干细胞移植术是治疗翼状胬肉较好的手术方法。

Objective This study aims to determine the prevalence of pterygium among workers aged 45 years and older in a seawater sahern in Jiangsu Province and identify the relationship among age, gender, environment, and pterygium. This study also observes the therapeutic effects of limbal stem cell autograft transplantation. Methods With the use of cluster random sampling method, we selected 12,062 workers （24124 eyes）, and the incidence, and prevalence of pterygium in the area were analyzed. Among 83 eyes of 76 cases with pterygium were operated on using limbal stem cell autograft transplantation. The operated patients were followed up for 10 months to 24 months. Results A total of 618 （5. 645% ） workers had pterygium. No statistical significant difference was found between men （ as a rate of 5. 484% ） and women （ as a rate of 5. 787% ） with pterygium （ P 〉 0. 05 ）. The prevalence of pterygium increased along with age （ P 〈 0.05 ）. It was higher in people aged 55 years to 64 years than that in people aged 45 eyes to 54 eyes. There was no difference between people aged 55 years to 64 years and people aged older than 65 years （ P 〉 0. 05 ）. Three of the 83 eyes operated had occurred recurrent pterygium after operation, with a recurrene rate of 3. 614%. Conclusion The prevalence of pterygium correlates to geographic setting, sun light and ultraviolet exposure, age, economic status. The key point of pterygium treatment focuses on the functional reconstructed of the corneal limbus. Limbal stem cell autograft transplantation is the ideal treat- ment method for pterygium.