翼状胬肉不同手术方法患者泪液功能的临床分析

Clinical analysis of different surgical methods on tear function in patients with pterygium

目的探讨两种不同手术方式治疗翼状胬肉对泪液功能的影响及影响因素。方法选取翼状胬肉患者40例(40只眼)随机分成两组:A组20个病人(20只眼)翼状胬肉切除联合冻干羊膜移植术;B组20个病人(20只眼)翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术。术前,术后1mo,术后3mo行泪膜破裂时间(BUT)、泪液分泌试验(SchirmerI)、角膜荧光素染色(CSF),评价翼状胬肉及翼状胬肉切除术后泪膜功能变化对患者生活质量的影响。结果两组病人术后1moBUT缩短,角膜荧光素染色增多,差异有统计学意义(p<0.05),而术后SchirmerI与术前相比无统计学意义,两组术后3moBUT,SchirmerI,CFS与术前相比无统计学意义,翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术组术后早期泪膜稳定性优于翼状胬肉切除联合冻干羊膜移植术,差异具有统计学意义(p<0.05)。结论翼状胬肉切除术早期对泪膜功能有影响。翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术早期对泪膜的影响小于翼状胬肉切除联合冻干羊膜移植术。

Objetive To explore the different surgical methods on tear function in patients with ptergium and its possible factors. Method Forty cases of pterygium patients （40 eyes） were randomly divided into two groups： A group of 20 patients （20 eyes） underwent pterygium excision combined with frozen dry amniotic membrane transplantation, B group of 20 patients （20 eyes） underwent pterygium excision combined with autologous limbalstem cell transplantation. Before and 1 month ,3 month after surgery, the tear film break-up time （BUT）, Sehirmer I test, conjunctiva fluoresce in staining （CFS） were examined, so as to evaluate the effects of tear function changes in pteryqium and on quality of patients life after pterygium excision o Results Both groups had shortened BUT and increased CFS at 1 month after the surgery, and the differences were significant （p〈0.05）, while the difference between postoperative and preoperative Sehirmer I was insignificant. There was no significant difference in BUT, Schirmer I, CFS postoperative and preoperative between two groups. Tear film stability of group B was obviously better than that of group A at early time postoperative （p〈O.OS）.Conclusion Pterygium excision affected tear film function at the early postoperative time. Influence of pterygium excision combined with autologous limbalstem cell transplantation on function of the tear film is less than that of pterygium excision combined with conjunctival flap grafting at early postoperative stage.