翼状胬肉单纯切除术与联合自体角膜缘干细胞移植术的临床疗效比较

Clinical effects observation of diffierent surgical removal of pterygium

目的比较翼状胬肉单纯切除术与联合自体角膜缘干细胞移植术两种不同的手术方式治疗原发性翼状胬肉的疗效。方法回顾性分析2013年11月~2014年10月在武汉科技大学附属天佑医院眼科就诊的28例（32只眼）原发性翼状胬肉患者的临床资料,其中行单纯翼状胬肉切除术的14例（16只眼）为A组,行翼状胬肉切除联合自体角膜缘干细胞移植术的14例（16眼）为B组。术后随访6~12月,观察两组复发率及角膜上皮修复时间。结果 A组16只眼中复发4只眼,复发率25.00%,B组16只眼中复发1只眼,复发率6.25%,A组复发率显著高于B组（P〈0.05）;A组角膜上皮平均修复时间（5.81±0.27）d长于B组角膜上皮平均修复时间（3.65±0.32）d（P〈0.05）。两组术中及术后均未发生严重并发症。结论翼状胬肉切除联合自体角膜缘干细胞移植术能够降低翼状胬肉术后的复发率,缩短角膜上皮的修复时间,是治疗翼状胬肉相对安全、行之有效的手术方式之一。

Objective To observe and compare the theraputic effects between simple pterygium excision and pterygium excision combined with limbus cornea stem cell transplantation in the treatment of primary pterygium. Methods This was a retrospective case series study. Thirty-two eyes of twenty-eight patients with primary pterygium including twenty-two eyes of eighteen males and ten eyes of 10 females in Tianyou Hospital Affiliated to Wuhan University of Science and Technology from Dec. 2013 to Oct. 2014 weredivided into two groups. Group A （ fourteen patients, sixteen eyes ） is of the cases of simple pterygium excision while group B （fourteen patients, sixteen eyes ） is of the cases of pterygium excision combined with limbus cornea stem cell transplantation. All patients were followed-up after the operation for 6-12 months to investigate the recurrence rate. Chi-square test was used to evaluate the recurrence rate between these two groups. Results Group A.- pterygium recurred in 4eyes （25% ）;Group B： pterygium recurred in 1 eyes （6.25 % ）. The recurrence rate of group A was significantly higher than group B（χ2= 5. 162 ,P〈0.05 ）. The average epithelium repair time was （ 5.81 ± 0.27 ） d in group A, and （ 3.65± 0.32 ） d in group B. There was significant difference （ P〈0.05 ）. No sever intraoperative and postoperative complications happened in two groups. Conclusion Pterygium excision combined with limbus cornea stem cell transplantation can reduce the recurrence rate, and shorten the epithelium repair time. Pterygium excision combined with autoallergie limbus cornea stem cell transplantation is one of safe and effective operation methods in treating pterygium.