翼状胬肉手术中干细胞移植与应用丝裂霉素C的效果对比

Comparative study on the efficacy between stem cells transplantation and intraoperative application of mitomycin C in pterygium surgery

目的对比自体角膜缘干细胞移植与术中应用丝裂霉素C两种手术方式治疗翼状胬肉的效果.方法前瞻性临床研究.分析郑州人民医院2014年6月至2017年1月共247例单眼、双眼和复发型三类翼状胬肉患者的临床资料.患者随机分为干细胞移植组和丝裂霉素组(MMC组).术后随访1年观察其手术效果.结果本研究包括单眼159例,双眼40例,复发者48例.单眼翼状胬肉患者中干细胞组和丝裂霉素组复发率分别为11.25%和20.25%(χ^2=2.431,P=0.119);双眼者中两组复发率分别为19.05%和15.79%(χ^2=0.000,P=1.000);复发者中两组复发率分别为12.50%和45.83%,丝裂霉素组高于干细胞组(χ^2=4.941,P=0.026).三类翼状胬肉患者中丝裂霉素组间复发型患者复发率高于单眼患者(χ^2=6.227,P=0.013).结论复发性翼状胬肉患者干细胞移植术复发率低于术中应用丝裂霉素C者,而在单眼和双眼两类患者中两种手术方式未见显著差别.

Objective To compare the efficacy between autologous limbal stem cells transplantation and intraoperative application of mitomycin C for the treatment of pterygium.Methods This was a prospective clinical study.The clinical data of 247 cases of three types of patients with monocular,binocular and recurrent pterygium,who were recruited from Jun.2014 to Jan.2017 in People’s Hospital of Zhengzhou were analyzed.The patients were randomly divided into stem cells transplantation group and mitomycin C(MMC)group.All the patients were followed up for 1 year postoperatively.The surgical efficacy were observed.Results There were 159 patients with monocular pterygium,40 patients with binocular pterygium,48 patients with recurrent pterygium.In patients with monocular pterygium,the recurrence rates of stem cells group and MMC group were 11.25%and 20.25%respectively(χ^2=2.431,P=0.119).In patients with binocular pterygium,the recurrence rates of two groups were 19.05%and 15.79%respectively(χ^2=0.000,P=1.000).In patients with recurrent pterygium,the recurrence rates of two groups were 12.50%and 45.83%,and the recurrence rate of MMC group was significantly higher than that of stem cells group(χ^2=4.941,P=0.026).During MMC groups in three types of patients,the recurrence rate of recurrent patients was significantly higher than that of monocular patients(χ^2=6.227,P=0.013).Conclusion In patients with recurrent pterygium,the recurrence rate of stem cells transplantation is lower than that of MMC group,but in patients with monocular and binocular pterygium,there is no significant difference between two surgical methods.