那素达联合聚乙二醇眼液在自体角膜缘干细胞移植治疗翼状胬肉中的应用研究

Effect of Naphcon-A eye drops combined with polyethylene glycol eye drops in treatment of pterygium patients with autologous limbal stem cell transplantation

目的评价那素达联合聚乙二醇眼液在自体角膜缘干细胞移植治疗翼状胬肉的临床效果。方法采用前瞻性队列研究,按照纳入及排除标准收集48例(62眼)翼状胬肉切除联合自体角膜缘干细胞移植术患者,将患者随机分为联合用药组和对照组;联合用药组在术前、术中、术后使用那素达、聚乙二醇和典必殊眼液,对照组仅术后用典必殊眼液。比较联合用药组与对照组患者在复发率、上皮愈合时间、眼表功能、并发症等之间的差异。结果联合用药组复发率为2.78%,对照组复发率为7.69%,2组差异无统计学意义(P>0.05);联合用药组平均上皮愈合时间为(5.07±1.23)d,对照组为(5.83±1.59)d,2组差异有统计学意义(P<0.05)。联合用药组与对照组患者手术前泪液分泌量、泪膜破裂检查时间测定值之间差异均无统计学意义(P>0.05);与手术前相比,联合用药组与对照组患者术后1个月的泪液分泌量、泪膜破裂检查时间均明显增加,差异均有统计学意义(P<0.01);联合用药组患者手术1个月后泪液分泌量、泪膜破裂检查时间亦均高于对照组患者,差异有统计学意义(P<0.01)。结论那素达联合聚乙二醇眼液在翼状胬肉切除联合自体角膜缘干细胞移植治疗中可缩短上皮愈合时间,改善眼表功能。

[Objective]To investigate the clinical efficacy of Naphcon-A eye drops combined with polyethylene glycol eye drops in treatment of pterygium patients with autologous limbal stem cell transplantation. [Methods]By using the prospective cohort study,48 cases（62 eyes） of pterygium with autologous limbal stem cell transplantation were collected according to the inclusion and exclusion criterias,and the patients were randomly divided into the combined treatment group and the control group. The combined treatment group was given the Naphcon-A eye drops,polyethylene glycol eye drops and Tobra Dex eye drops before,during and after operation. The control group was treated with Tobra Dex eye drops after operation. The relapse rate,epithelial healing time,ocular surface function and complications were compared between two groups. [Results]The relapse rate of the combined treatment group and the control group was 2.78% and 7.69% respectively,and the difference was not significant（P〈0.05）. The average epithelial healing time of the combined treatment group and the control group was（5.07±1.23）days and（5.83±1.59）days respectively,and there was significant difference（P〈0.05）. No significant differences were observed in lacrimal secretion and tear film break up time before operation between two groups（P〉0.05）. The lacrimal secretion and tear film break up time 1 month after operation were significantly higher than those before operation in both two groups（P〈0.01）. One month after operation,the lacrimal secretion and tear film break up time of the combined treatment group were higher than those of the control group,and the differences were significant（P〈0.01）.[Conclusion]Naphcon-A eye drops combined with polyethylene glycol eye drops can shorten the epithelial healing time and improve the ocular surface function in patients undergoing the pterygium excision combined with autologous limbal stem cell transplantation.