锁边缝合结合连续缝合在翼状胬肉切除联合结膜转位术中的应用

Application of interlocking suture combined with simple continuous suture in pterygium excision with coniunctivai translocation

目的：观察翼状胬肉切除联合结膜瓣转位术中,锁边缝合结合单纯连续缝合法的临床效果。方法：选取2011-08/2014-06在我院行翼状胬肉切除联合结膜转位术的患者62例78眼,按照术中结膜瓣缝合法分为两组,A组36眼采用间断缝合法缝合结膜瓣,B组42眼采用锁边缝合与单纯连续缝合相结合方法缝合,术后1wk裂隙灯下拆线,随访3mo。比较两组术中缝合结膜瓣时间,术后1wk拆线时间及患者异物感程度。同时观察结膜切口对位情况、结膜炎症反应及胬肉复发率。结果：术后1,3d;1wk,A组患者异物感较B组明显;术中缝合结膜瓣时间A组为14.2±3.1min,B组为10.4±2.5min,有统计学差异（t=5.99,P〈0.01）;拆线时间A组为9.5±2.2min,B组为5.3±2.7min,有统计学差异（t=7.45,P〈0.01）。术后A组共有12眼出现结膜切口裂开,4眼在术后1-2mo复发。B组共有6眼出现结膜切口裂开或结膜瓣脱位,2眼在术后2mo复发。结论：锁边缝合结合单纯连续缝合法缝合结膜快捷有效,缝合线结少,可减轻翼状胬肉术后患者不适,并使拆线更加快速安全。

AIM：To observe the clinical outcomes of interlocking suture combined with simple continuous suture in pterygium excision with conjunctival translocation.METHODS：Sixty- two patients（78 eyes） with pterygium from August,2011 to June,2014 were randomly divided into two groups with 36 eyes in group A and 42 eyes in group B.Interrupted suture and interlocking suture combined with simple continuous suture were performed in group A and group B respectively.The time taking in suture during surgery and in taking out stitches 1wk after operation were recorded.Suture conjunctival flap time,postoperative 1wk stitching time and foreign body sensation of patients were compared in two groups.Intertion status of conjunctival incision,inflammatory reaction and pterygium recurrence were also observed during the 3mo follow-up.RESULTS：Eyewinker feeling was much weaker reported by patients in group B than group A at 1,3d and 1wk postoperatively.The average surgical time was 14.2 ±3.1min for group A and 10.4 ±2.5 min for group B（t =5.99,P〈 0.01）.The average time of removing stitches was 9.5±2.2min in group A and 5.3±2.7min in group B（t= 7.45,P〈0.01）.Pterygium recurred in 4 cases in group A and 2 cases in group B.Conjunctival wound dehiscence occurred in 12 cases in group A and 6 cases in group B.CONCLUSION：Interlocking suture combined with simple continuous suture is a good way of suture in pterygium excision.It can improve the efficiency of operation and removal of the suture and reduce complication and discomfort of the operation.