翼状胬肉切除术联合无缝线自体结膜移植术治疗翼状胬肉的有效性及安全性分析

Effect and Safety Analysis of Pterygium Excision Combined with Sutureless Autologous Conjunctival Transplantation for Pterygium

目的分析翼状胬肉切除术联合无缝线自体结膜移植术的有效性和安全性。方法选取2020年7月—2022年12月本院眼科接收的60例翼状胬肉患者为研究对象,随机将其分为参照组与实验组,每组30例。分别施行翼状胬肉切除术联合经典缝线自体结膜移植术与无缝线自体结膜移植术,对比两组治疗前后眼部情况、手术相关指标、并发症发生情况及复发情况。结果治疗前,两组眼部情况差异无意义(P>0.05);治疗后,实验组泪膜破裂时间长于参照组,泪液分泌试验、裸眼视力均高于参照组,而角膜散光度低于参照组,组间差异有统计学意义(P<0.05)。实验组手术时间、术后结膜愈合时间、不适症状持续时间均短于参照组,组间差异有统计学意义(P<0.05)。实验组并发症发生率、复发率均低于参照组,组间差异有统计学意义(P<0.05)。结论在翼状胬肉治疗中,翼状胬肉切除术联合无缝线自体结膜移植术不仅更有利于改善患者眼部情况,还能有效减少并发症,明显降低复发率,提高手术治疗效果及安全性,值得推广。

Objective To analyze effect and safety of pterygium excision combined with sutureless autologous conjunctival transplantation.Methods The paper chose 60 patients with pterygium admitted to ophthalmology department from July 2020 to December 2022,and divided them into control group and experimental group randomly,with 30 cases in each group,treated with pterygium excision combined with classic suture autologous conjunctival transplantation and sutureless autologous conjunctival transplantation separately.Eye condition,surgical related indicators,incidence of complications,and recurrence were compared before and after treatment between two groups.Results Before treatment,there was no significant difference in eye condition between two groups,P>0.05.After treatment,tear film rupture time in experimental group was(9.79±1.15)s,longer than(8.51±1.13)s in reference group,tear secretion test was(9.13±1.04)mm/5min,naked eye vision was(0.74±0.11),higher than(7.32±1.15)mm/5min and(0.62±0.12)s in reference group respectively.Corneal astigmatism was(0.72±0.17)°,lower than(1.23±0.12)°in reference group,with(P<0.05).Surgical time(28.92±2.37)minutes,postoperative conjunctival healing time(8.13±1.04)days,and duration of discomfort symptoms(1.36±0.26)days in experimental group was shorter than surgical time(36.59±1.41)minutes,postoperative conjunctival healing time(12.32±1.15)days,and duration of discomfort symptoms(4.67±1.15)days in reference group,with(P<0.05).Incidence of complications and recurrence rate in experimental group were 6.67%and 3.33%,lower than 24.24%and 18.18%in reference group,with(P<0.05).Conclusion Combination of pterygium excision and sutureless autologous conjunctival transplantation can improve eye condition,reduce complications and recurrence rate significantly,and improve surgical treatment effect and safety of pterygium patients,which is worthy of promotion.