不同手术方法对降低翼状胬肉复发的疗效比较研究

Comparative study on the effect of different surgical methods on reducing the recurrence of pterygium

目的比较单纯切除术、角膜缘干细胞移植及羊膜移植术降低翼状胬肉复发的疗效。方法选取2017年1月至2018年6月于本院接受手术治疗的120例翼状胬肉患者,以等距随机抽样法分为3组,每组40例。对照组采取单纯切除术治疗,角膜缘干细胞移植组在对照组基础上加用角膜缘干细胞移植治疗,羊膜移植组在对照组基础上加用羊膜移植术治疗。术后随访12个月,对3组近期临床疗效、复发率进行对比。结果术前3组泪膜破裂时间、泪液分泌试验结果比较差异无统计学意义,术后7 d、1个月、3个月均较术前提高,差异具有统计学意义(P<0.05),且角膜缘干细胞移植组>羊膜移植组>对照组,差异具有统计学意义(P<0.05);术后随访12个月,角膜缘干细胞移植组复发率<羊膜移植组<对照组,差异具有统计学意义(P<0.05)。结论在翼状胬肉治疗中单纯切除术、角膜缘干细胞移植及羊膜移植术均能够取得较为理想的疗效,但角膜缘干细胞移植疗效最佳且术后复发率最低,可作为临床治疗的优选方法,值得推广应用。

Objective To compare the efficacy of simple resection,limbal stem cell transplantation and amniotic membrane transplantation in reducing the recurrence of pterygium.Methods 120 patients with pterygium who underwent surgery in our hospital from January 2017 to June 2018 were divided into three groups,with 40 cases in each group.The control group was treated with simple resection,the limbal stem cell transplantation group was treated with limbal stem cell transplantation on the basis of the control group,and the amniotic membrane transplantation group was treated with amnion transplantation on the basis of the control group.The patiens were followed up for 12 months and the clinical efficacy and recurrence rate were compared among three groups.Results There was no significant difference in tear rupture time and tear secretion test results among the three groups.There was statistical difference among the 7 days,1 month and 3 months after operation(P<0.05),and limbal stem cell transplantation group>amniotic membrane transplantation group>control group,there was statistical difference(P<0.05).Postoperative followup 12 months,limbal stem cell transplantation group recurrence rate<amniotic transplantation group<control group,there was statistical difference(P<0.05).Conclusion In the treatment of pterygium,simple resection,limbal stem cell transplantation and amniotic membrane transplantation can achieve better results,but limbal stem cell transplantation has the best effect and the lowest recurrence rate,which can be used as the preferred method for clinical treatment,and promote the application.