角膜缘干细胞移植与丝裂霉素C在翼状胬肉治疗中的疗效比较

Effects comparison between corneal limbal stem cell transplantation and mitomycin in treatment of pterygium

目的 比较翼状胬肉切除术中联合自体角膜缘干细胞移植或单纯应用丝裂霉素C的临床疗效。方法 选择2015年1~12月于我院行翼状胬肉切除术的原发性单眼翼状胬肉患者60例,根据治疗方式的不同分为观察组与对照组,每组30例。观察组患者行翼状胬肉切除术联合自体角膜缘干细胞移植,对照组患者行翼状胬肉切除术联合应用丝裂霉素C,比较两组患者的泪膜破裂时间、角膜修复效果、并发症、复发率等。结果 1两组患者术前、术后1.5个月的泪膜破裂时间比较,差异无统计学意义（P〉0.05）,但观察组术后6个月的泪膜破裂时间明显长于对照组,组间差异有统计学意义（P〈0.05）;2术后1周,观察组角膜修复有效率为93.3%（28/30）,对照组角膜修复有效率为76.6%（23/30）,组间差异有统计学意义（P〈0.05）;3术后6个月,观察组的复发率好于对照组,但组间差异无统计学意义（P〉0.05）。结论 角膜缘干细胞移植与单纯丝裂霉素C治疗翼状胬肉均具有良好的效果,角膜缘干细胞移植治疗本病稳定性更高,更为可靠,值得推广;而从另外一方面看,丝裂霉素C使用相对更便捷,费用更低。临床可根据患者实际情况,选择最合适的治疗方式。

Objective To compare the clinical effects of corneal＊limbal stem cell autograft transplantation and mito- mycin C in pterygium resection. Methods 60 patients with primary single-eye pterygium treated by pterygium resection in our hospital from January to December 2015 were selected arid divided based on their treatment methods into obser- vation group and control group, each with 30 cases. Patients in the observation group were given pterygium resection ＋ corneal limbal stem cell autograft transplantation, while those in the control group were given mitomycin C in pterygium resection. The breakup time of tear film, repair effect of cornea, complications, and recurrence rate were compared be- tween two groups. Results （1） There was no significant difference in breakup time of tear film before treatment and at 1.5 months after treatment between two groups（P〉0.05i. However, the breakup time of tear film was significantly longer in the observation group than in the control group at 6 months after operation （P〈0.05）. （2） At 1 week after operation, the response rate of corneal repair was 93.3%（28/30） in the observation group, and was 76.6%（23/30）in the control group, showing significant difference between the two groups （P〈0.05）. （3） At 6 months after operation, the recurrence rate was lower in the observation group than that in the control group, but without significant differences （P〉0.05）. Conclusion Corneal limbal stem cell transplantation and simple mitomycin have favorable effects in treatment of ptery- gium and corneal limbal stem cell transplantation is more stable and reliable, thus is worthy to be promoted. On the other hand, application of mitomycin is more convenient with lower cost. Therefore, the preferred procedure can be se- lected based on the specific conditions of patients.