三种不同术式治疗翼状胬肉临床效果对比观察以及患者术后满意度影响因素调查分析

Comparative observation of clinical effects of three different operations for pterygium and investigation of the influencing factors of postoperative satisfaction of patients

目的比较三种手术方式对于翼状胬肉临床效果以及患者术后满意度影响因素分析。方法回顾性病例对照研究。选择蚌埠市第二人民医院眼科翼状胬肉患者共142例(142只眼),分为:A组(普通干细胞移植组)48只眼;B组(普通干细胞移植合并绷带镜保护组)48只眼;C组(无缝线干细胞移植合并绷带镜保护组)46只眼,术后1 d、1周、1个月、3个月、1年随访观察,比较3组患者术后视力、角膜上皮愈合情况,以及患者术后1个月满意度调查。结果3组患者术后1个月矫正视力无统计学差异;3组角膜上皮愈合时间、结膜水肿褪去时间、术后眼磨天数均有统计学差异(P<0.05);患者对于翼状胬肉术后满意度与手术方式、来院途径、术前宣教、医保类型、患者学历水平均有关系。结论无缝线角膜缘干细胞移植合并绷带镜保护的手术方式患者术后角膜上皮愈合时间、结膜水肿褪去时间、术后眼磨天数较其他两组方式均缩短;患者术后满意度均高于其他两组。

Objective To compare the clinical effects of three surgical methods in the treatment of pterygium,and analyze the influencing factors of postoperative satisfaction.Methods retrospective case series study.142 eyes of 142 patients with pterygium were selected from the Second People’s Hospital of Bengbu and divided into three groups according to different surgical methods.The A group(48 eyes)with ordinary stem cell transplantation.The B group(48 eyes)was treated with stem cell transplantation combined with bandage microscope protection.The C group(46 eyes)was treated with suture-free stem cell transplantation combined with bandage endoscopic protection.The difference of recurrence,postoperative vision and corneal epithelial healing of patients in the three groups were compared at 1 day,1 week,1 month,3 months and 1 year after surgery,as well as the satisfaction survey of patients at 1 month after the surgery.Results There was no significant difference in corrected visual acuity among the three groups at 1 month after the surgery.The healing time of corneal epithelium,the time of conjunctival edema fading and postoperative eye wear days were significantly different among the three groups(P<0.05).The satisfaction degree of patients with pterygium surgery was related to the operation method,hospital approach,preoperative education,medical insurance type and education level of patients.conclusions The healing time of corneal epithelium,the regression time of conjunctival edema and the time of foreign body sensation and pain after surgery were shorter in patients with suture free limbal stem cell transplantation combined with bandage mirror protection,andthe postoperative satisfaction was higher.