联合自体角膜缘干细胞移植术和单纯切除术治疗翼状胬肉疗效比较

Compare the clinical efficacy of pterygium treaded by combined with autologous limbal stem cell transplantation and simple pterygium excision

目的 通过对联合白体角膜缘干细胞移植术和单纯切除术治疗翼状胬肉的临床疗效的比较,评价两种手术方式的治疗效果.方法 临床病例对照研究.对201 1年1月至2013年12月在信阳职业技术学院附属医院眼科就诊的136例（169只眼）翼状胬肉患者,原发性108例（137只眼）,复发性28例（32只眼）.按随机表顺序分为A组和B组.A组68例（84只眼）采用翼状胬肉单纯切除术;B组68例（85只眼）采用翼状胬肉切除联合自体角膜缘干细胞移植术,术后随访6～18个月.A组失访5例（5只眼）,B组失访4例（4只眼）.结果 角膜创面上皮愈合时间：A组为5～9 （6.3±1.3）d;B组为3～5（3.9±1.2）d,两组比较差异有统计学意义（t =3.318,P＜0.05）.A组16只眼复发,复发率为20.25％ （16/79）;B组3只眼复发,复发率为3.70％（3/81）,两组比较差异有统计学意义（x2=4.39,P ＜0.05）.结论 联合白体角膜缘干细胞移植术治疗翼状胬肉可以缩短角膜创面上皮愈合时间,降低复发率,是一种有效安全地治疗方法,值得推广运用.

Objective To compare the clinical efficacy of pterygium treaded by combined with autologous limbal stem cell transplantation and simple pterygium excision,and to evaluate the therapeutic effects,safety and feasibility of two different surgery.Methods One hundred and thirty-six cases （169 eyes） with pterygium were randomly assigned into 2 groups and operated,108 cases （137 eyes） were primary and 28 cases （32 eyes） were recurrent pterygium.Simple pterygium excision （group A） was adopted in 84 eyes of 68 cases.Limbal stem cell transplantation （group B） was adopted in 85 eyes of 68 cases.The postoperative follow-up periods were 6 to 18 months.Results The average epithelial recovering time of corneal wound was 6.3 days and 3.9 days,respectively,the difference was statistical significant （t =3.318,P ＜0.05）.Recurrence of 22 eyes was noted in simple pterygium excision group （group A）,the recurrent rate was 20.25％,however recurrence of 3 eyes was noted in limbal stem cell transplantation group （group A）,and the recurrent rate was 3.70％.There was statistical significant difference between two groups （x2=4.39,P ＜0.05）.Conclusions Combined with autologous limbal stem cell transplantation can improve epithelial recovering time of corneal wound and decrease the recurrent rate.It is an effective and safe method for treating the pterygium and is worth to spreading.