一种改良翼状胬肉手术方法与传统翼状胬肉手术方法的对比研究

Comparative study of modified and traditional pterygium surgery

目的对改良翼状胬肉手术方法进行安全性评估的研究。方法 188例翼状胬肉患者随机分为实验组和对照组。实验组接受改良方法进行翼状胬肉手术。对照组按照《眼科手术图谱》传统翼状胬肉切除术方法进行手术。记录所有患者手术时间、术后角膜上皮修复时间。术后每周随访,记录术后1周、2周、3周、4周时结膜充血情况及结膜充血完全消退时间。随访3个月,记录发生角巩膜溃疡、结膜肉芽以及翼状胬肉复发的病例数。结果实验组有96人完成随访,对照组有92人完成随访。实验组患者角膜上皮修复时间为2.42±0.68天,对照组为4.27±1.05天,P<0.05,差别有统计学意义;实验组结膜充血评分术后1周、2周、3周、4周时分别为3.31±0.47、2.76±0.74、1.89±0.860.94±0.70,对照组分别为3.84±0.37、3.58±0.67、2.93±0.71、1.85±0.78,两两比较P<0.05,差别有统计学意义。结膜充血消退时间实验组为5.15±0.92周,对照组为7.20±1.08 P<0.05,差别有统计学意义。实验组未发生结膜肉芽,对照组为14例,P<0.05,差别有统计学意义。实验组发生角巩膜溃疡4例、复发4例,对照组为7例、5例,P>0.05,差别无统计学意义。结论改良的翼状胬肉手术方法在术后角膜上皮修复时间、术后结膜充血程度、结膜充血消退时间、结膜肉芽发生率上忧于传统手术方法,差别有统计学意义。在角膜溃疡发生率、翼状胬肉复发率上改良手术方法与传统手术差别无统计学意义。

Objective To To study the security of the modified pterygium surgery. Methods 188 patients of pterygium were divided into two groups. The experimental group was treated by the modified pterygium surgery, and the control group was treated by the traditional surgery. The time of the corneal epithelium recovering and the conjunctival congestions were observed. 1,2,3 and 4 weeks after the surgery, the conjunctival congestions of the two groups were recorded. Then the incidence of conjunctival granulation, corneal ulcer, pterygium recurrence was compared. Results The time of epithelium recovering was 2.42±0.68 days in experimental group,4.27±1.05 days in the other control（P〈0.05）. The conjunctival congestions scores of the experimental group at 1,2,3,4 weeks was 3.31±0.47、2.76±0.74、1.89±0.860.94±0.70,and that of the control group was 3.84±0.37、3.58±0.67、2.93±0.71、1.85±0.78（P〈0.05）.There were 4 cases of corneal ulcer and 4 cases of recurrence occurred in experimental group, compared with 7 cases of corneal ulcer and 5 cases of recurrence in control group.No case of conjunctival granulation occurred in experimental group and 14 cases occurred in control group. Conclusion The modified pterygium surgery was better than the traditional surgery at the time of the corneal epithelium recovering, conjunctival congestions scores. There was no different in security between two methods.