四种不同手术方式治疗翼状胬肉的疗效分析

Efficacy analysis of four different surgical methods for pterygium

目的探讨四种不同手术方式治疗翼状胬肉的疗效。方法 169例(212眼)翼状胬肉患者,根据手术方式不同分为Ⅰ组(单纯手术切除术, 23眼)、Ⅱ组(手术切除联合自体结膜移植术, 72眼)、Ⅲ组(手术切除联合自体角膜缘干细胞移植术, 81眼)、Ⅳ组[丝裂霉素(MMC)注射后联合手术切除术,36眼]。比较四组患眼复发情况及不同胬肉分级患眼复发情况。结果Ⅰ组复发率为39.13%,Ⅱ组复发率为11.11%,Ⅲ组复发率为4.94%,Ⅳ组复发率为13.89%。Ⅰ组复发率高于Ⅱ、Ⅲ、Ⅳ组,差异均具有统计学意义(χ~2=9.314、19.148、4.941, P<0.05)。Ⅱ、Ⅲ、Ⅳ组组间两两比较,差异均无统计学意义(P>0.05)。Ⅰ°胬肉复发率为2.33%,Ⅱ°胬肉复发率为13.46%,Ⅲ°胬肉复发率为16.92%。Ⅰ°胬肉复发率低于Ⅱ°、Ⅲ°,差异均具有统计学意义(χ~2=4.117、5.584, P<0.05)。Ⅱ°、Ⅲ°胬肉比较,差异无统计学意义(P>0.05)。结论自体结膜移植术、自体角膜缘干细胞移植术及MMC注射后联合手术切除术均可以减少翼状胬肉术后复发。

Objective To discuss the efficacy of four different surgical methods for the treatment of pterygium. Methods A total of 169 cases(212 eyes) pterygium patients were divided by different surgical methods into group Ⅰ(simple surgical excision, 23 eyes), group Ⅱ(surgical excision combined with autologous conjunctival transplantation, 72 eyes), group Ⅲ(surgical excision combined with autologous limbal stem cell transplantation, 81 eyes) and group Ⅳ[surgical resection after injection of mitomycin(MMC), 36 eyes]. Comparison were made on recurrence of involved eyes in four groups and recurrence of involved eyes of different grades of pterygium. Results Group Ⅰ had recurrence rate as 39.13%, which was 11.11% in group Ⅱ, 4.94% in group Ⅲ and 13.89% in group Ⅳ. Group Ⅰ had higher recurrence rate than group Ⅱ,Ⅲ and Ⅳ, and their difference was statistically significant(χ^2=9.314, 19.148, 4.941, P<0.05). Group Ⅱ,Ⅲ and Ⅳ had no statistically significant difference(P>0.05). The recurrence rate of Ⅰ° pterygium was 2.33%, which were 13.46% of Ⅱ°pterygium and 16.92% ofpterygium. The recurrence rate of Ⅰ° pterygium was lower than Ⅱ° and Ⅲ°pterygium, and the difference was statistically significant(χ^2=4.117, 5.584, P<0.05). There was no statistically significant in Ⅱ° and Ⅲ°pterygium(P>0.05). Conclusion Autologous conjunctival transplantation, autologous limbal stem cell transplantation and combined operation after MMC injection can reduce the recurrence of pterygium.