三种不同术式切除翼状胬肉的临床对比观察

Clinical comparative study of three different surgical excision for pterygium

目的：探讨三种不同手术方式切除翼状胬肉的临床疗效。方法选择本院2012年4月～2014年4月90例原发翼状胬肉患者,按照随机数字表法分为A组、B组、C组各30例。 A组给予常规翼状胬肉切除联合丝裂霉素治疗,B组给予翼状胬肉切除联合羊膜移植治疗,C组给予翼状胬肉切除联合自体角膜缘干细胞移植治疗。观察并记录3组的治疗情况及随访效果。结果3组患者创面均一期愈合（治愈率为100.00%）,治愈率差异无统计学意义（P＞0.05）,但A组角膜创面愈合时间显著长于B、C组,差异有统计学意义（P＜0.05）；C组随访过程中无复发（复发率为0）,A组复发率为16.67%,B组复发率为20.00%,C组复发率与A、B组比较,差异有统计学意义（P＜0.05）；C组患者满意度评分显著高于A、B组,差异有统计学意义（P＜0.05）。结论应用翼状胬肉切除联合自体角膜缘上皮肝细胞移植术治疗翼状胬肉可获得满意疗效,使患者尽快恢复健康,有效降低其术后复发率,保障患者预后,有利于维持良好的医患关系。

Objective To discuss the clinical curative effect of three different surgical excision for pterygium. Methods 90 cases of patients with primary pterygium in our hospital from April 2012 to April 2014 were chosen,and were ran-domly divided into group A,group B and group C through the stochastic indicator method.Group A were given with con-ventional pterygium excision combined with mitomycin therapy,group B were given with pterygium excision combined with amniotic membrane transplantation treatment,group C were given with pterygium excision combined with autolo-gous limbal epithelial liver cell transplantation therapy.The clinical effect and follow-up results were observed and recorded. Results The wounds were primary healed in three groups,the cure rate of three groups were all 100.00%,there was no significant difference （P〉0.05）,but the corneal wound healing time of group A was longer than that of group B and group C,the difference was significant （P〈0.05）;There was no recurrence in group C during follow-up,the recurrence rate in group A was 16.67%,group B was 20.00%,group C compared with group A and group B,there was significant differ-ence （P〈0.05）;Patient satisfaction of group C was higher than that of group A and group B,the difference was significant （P〈0.05）. Conclusion Pterygium excision combined with autologous limbal epithelial liver cell transplantation in the treatment of pterygium can obtain satisfactory curative effect,make the patient back to health as soon as possible,effec-tively reduce the postoperative recurrence rate,guarantee the prognosis,conducive to maintain a good doctor-patient re-lationship.