翼状胬肉切除联合自体角膜缘干细胞移植对创面上皮修复及复发的影响

Pterygium Excision Combined with Autologous Limbal Stem Cell Transplantation for wound Epithelial Repair and Effect of Recurrence

目的探讨分析翼状胬肉切除联合自体角膜缘干细胞移植对创面上皮修复及复发的影响。方法随机选取本院2018年4月至2019年6月收治的84例(132眼)翼状胬肉患者,按数字表法均等分为42例(66眼)对照组和42例(66眼)试验组,对照组采用翼状胬肉切除术治疗,试验组采用翼状胬肉切除联合自体角膜缘干细胞移植治疗,对比两组患者的创面愈合时间、复发情况以及并发症的发生率。结果试验组患者创面平均愈合时间(3.37±1.17)d,明显短于对照组的(6.52±2.48)d;且试验组共复发2眼(3.03%),远低于对照组的14眼(21.21%),组间差异可比(P<0.05)。此外,试验组发生创面愈合不良、浅层点状角膜、睑球粘连等术后并发症发生率是7.14%,显著低于对照组的28.57%,差异显著(P<0.05)。结论相比于采取单一切除翼状胬肉的治疗方式,翼状胬肉切除联合角膜缘干细胞移植的治疗效果更好,自体角膜缘干细胞更贴近患者生理状态的角膜表面,而且,更有利于修复患者的创面,降低患者发生术后复发以及并发症的概率,值得在临床治疗中广泛应用。

Objective To investigate and analyze the effect of pterygium excision combined with limbal stem cell autograft transplantation on wound epithelial repair and recurrence.Methods Eighty-four cases(132 eyes)of pterygium patients admitted to our hospital from April 2018 to June 2019 were randomly selected and equally divided into 42 cases(66 eyes)control group and 42 cases(66 eyes)experimental group according to the digital table method.The control group was treated with pterygium excision,while the experimental group was treated with pterygium excision combined with autologous limbal stem cell transplantation.The wound healing time,recurrence and incidence of complications of the two groups were compared.Results The average wound healing time of the experimental group was(3.37±1.17)d,which was significantly shorter than that of the control group(6.52±2.48)d;The recurrence rate in the experimental group was 2 eyes(3.03%),much lower than that in the control group 14 eyes(21.21%),and the difference between the groups was comparable(P<0.05).In addition,the incidence of postoperative complications such as poor wound healing,superficial punctate cornea and symblepharon in the experimental group was 7.14%,significantly lower than 28.57% in the control group,with significant difference(P<0.05).Conclusion Pterygium excision combined with limbal stem cell transplantation has a better therapeutic effect than single excision of pterygium.Autologous limbal stem cells are closer to the corneal surface of the patient's physiological state.Moreover,it is more conducive to repairing the wound surface of the patient and reducing the probability of postoperative recurrence and complications of the patient.It is worthy of wide application in clinical treatment.