翼状胬肉切除术后行两种不同移植方案治疗翼状胬肉的效果对比

Comparison of two different transplantation schemes for the treatment of pterygium after pterygium resection

目的比较翼状胬肉切除术后行两种不同移植方案治疗翼状胬肉的效果。方法选取2020年6月至2021年6月瑞金市人民医院收治的108例(108眼)翼状胬肉患者作为研究对象,按照随机数字表法分为A组与B组,每组54例(54眼)。A组采用翼状胬肉切除联合羊膜移植术治疗,B组采用翼状胬肉切除联合带角膜缘干细胞的自体结膜移植术治疗。比较两组临床疗效、最佳矫正视力、眼表疾病指数(OSDI)评分、泪膜功能指标、术后并发症发生情况。结果术后3个月,B组治疗总有效率高于A组,差异有统计学意义(P<0.05)。术后3个月,两组OSDI评分均低于术前,且B组低于A组,差异有统计学意义(P<0.05)。术后3个月,两组最佳矫正视力均优于术前,且B组优于A组,差异有统计学意义(P<0.05)。术后3个月,两组BUT、SⅠT均长于术前,且B组长于A组,差异有统计学意义(P<0.05)。术后3个月期间,两组均未发生现胬肉组织增生或新生血管等相关并发症。结论翼状胬肉切除联合带角膜缘干细胞的自体结膜移植术及羊膜移植均可有效改善泪膜功能,减轻干眼症症状,但联合带角膜缘干细胞的自体结膜移植术更利于患者术后泪膜功能及干眼症状的改善。

Objective To compare the effects of two different transplantation schemes for the treatment of pterygium after pterygium resection.Methods 108 patients(108 eyes)with pterygium admitted to Ruijin People's Hospital from June 2020 to June 2021 were selected as the study sub-jects,and they were randomly divided into the group A and the group B according to the random number table method,with 54 cases(54 eyes)in each group.The group A was treated with pterygium excision combined with amniotic membrane transplantation,while the group B was treated with pterygium resection combined with autologous conjunctival transplantation with corneal limbal stem cells,the clinical efficacy,best corrected visual acuity,ocular surface disease index(OSDI)score,tear film function indicators,and incidence of postoperative complications were compared between two groups.Results At 3 months after operation,the total effective rate of treatment in the group B was higher than that in the group A,and the dif-ference was statistically significant(P<0.05).At 3 months after operation,the OSDI scores of the two groups were lower than those before opera-tion,and the group B was lower than the group A,the difference was statistically significant(P<0.05).At 3 months after operation,the best correct-ed visual acuity of the two groups was better than that before operation,and the group B was better than that in the group A,the difference was statis-tically significant(P<0.05).At 3 months after operation,BUT and SIT in both groups were longer than those before operation,and the group B were longer than the group A,the differences were statistically significant(P<0.05).During the 3 months after operation,no complications such as pteryg-ium tissue hyperplasia or neovascularization occurred in both groups.Conclusion Pterygium resection combined with autologous conjunctival trans-plantation with corneal limbal stem cells and amniotic membrane transplantation can effectively improve tear film function and alleviate dry eye symptoms,but autologous conjunctival transplantation combined with corneal limbal stem cells is more conducive to the improvement of postopera-tive tear film function and dry eye symptoms in patients.