连续缝合埋线法在翼状胬肉切除联合角膜缘干细胞移植术中的应用

Application of continuous stitching and burying suture in pterygium excision combined with limbal stem cell transplantation

目的探讨连续缝合埋线法在翼状胬肉切除联合角膜缘干细胞移植术中的应用疗效。方法70例原发性翼状胬肉患者随机分为观察组和对照组。两组均采用翼状胬肉切除联合角膜缘干细胞移植原位缝合术治疗,对照组采用间断缝合法,观察组采用连续缝合埋线法。比较两组的疼痛评分、眼表体征评分、泪膜破裂时间、并发症及复发率。结果(1)术后6小时两组疼痛评分无统计学差异(Z=-0.314,P=0.754);术后1日、2日观察组疼痛评分均低于对照组(Z_(术后第1日)=-2.842,P_(术后第1日)=0.004;Z_(术后第2日)=-2.403,P_(术后第2日)=0.016)。(2)术后1日、2日观察组眼表体征均优于对照组(Z_(术后第1日)=-2.446,P_(术后第1日)=0.014;Z_(术后第2日)=-2.526,P_(术后第2日)=0.012);术后1周两组眼表体征无统计学差异(Z=-1.358,P=0.175)。(3)术后1周观察组泪膜破裂时间优于对照组(t=2.135,P=0.036),术后4周两组泪膜破裂时间无统计学差异(t=0.989,P=0.326)。(4)术后4周及术后3个月观察组眼表并发症评分均优于对照组(Z_(术后第4周)=-2.019,P_(术后第4周)=0.044;Z_(术后第3月)=-2.945,P_(术后第3月)=0.003)。(5)两组复发率无统计学差异(P=0.607)。结论翼状胬肉切除及角膜缘干细胞移植术中采用连续缝合埋线法,可缓解术后的眼部刺激症状、减轻眼表炎症、促进眼表重建。

Objective To investigate the clinical effect of continuous stitching and burying suture in pterygium excision and limbal stem cell transplantation.Methods 70 patients with primary pterygium were randomly divided into observation group and control group.Both groups were treated with modified pterygium excision combined with limbal stem cell transplantation,in which the control group was sutured with conventional interrupted suture,and the observation group was sutured with continuous stitching and burying suture method.Pain score,ocular surface sign score,breaking up time,complications and recurrence rate of the two groups were observed and compared.Results(1)Pain score:There was no significant difference between the two groups at 6 hours after operation(Z=-0.314,P=0.754).The score of the observation group was lower than that of the control group on the 1st and 2nd day after surgery,and the difference was statistically significant(Z_(1st)=-2.842,P_(1st)=0.004;Z_(2nd)=-2.403,P_(2nd)=0.016).(2)Ocular surface sign score:The observation group was superior to the control group on 1st and 2nd day after surgery,and the differences were statistically significant(Z_(1st)=-2.446,P_(1st)=0.014;Z_(2nd)=-2.526,P_(2nd)=0.012).However,there was no statistical difference between the two groups at 1 week after surgery(Z=-1.358,P=0.175).(3)Breaking up time:The breaking up time in the observation group was better than that in the control group one week after operation,and the difference was statistically significant(t=2.135,P=0.036).However,there was no significant difference in breaking up time between the two groups at 4 weeks after surgery(t=0.989,P=0.326).(4)Complications:The scores of the observation group were better than those of the control group 4 weeks and 3 months after surgery,and the differences were statistically significant(Z_(4w)=-2.019,P_(4w)=0.044;Z_(3mon)=-2.945,P_(3mon)=0.003).(5)Recurrence rate:There was no significant difference in recurrence rate between the two groups(P=0.607).Conclusions The continuous stitching and burying suture was used in pterygium excisions and limbal stem cell transplantation can relieve postoperative ocular irritation symptoms,reduce ocular surface inflammation and promote ocular surface reconstruction.