翼状胬肉切除3种治疗方式的临床疗效观察

Observe the Clinical Curative Effect of the Excision of Pterygium of 3 Different Treatment Methods

目的:观察单纯性翼状胬肉切除术、翼状胬肉切除术+锶-90照射、翼状胬肉切除术+自体角膜缘干细胞移植术的临床疗效与术后复发率的情况。方法:翼状胬肉切除术+锶-90照射组(A组)32例40眼,单纯性翼状胬肉切除术组(B组,对照组)31例39眼,翼状胬肉切除术+自体角膜缘干细胞移植术组(C组)33例40眼,随机分为A,B,C组,术后复发率采用2检验,观察时间:3~26月(平均16.35±10.29)。结果:术后疗效依据Prabhasawat等提出的分级标准,进行裂隙灯下疗效评定,其中4级为真性胬肉复发。A组4级19眼(47.5%),B组4级24眼(61.53%),C组4级3眼(7.5%)。C组复发率(7.5%)明显低于A组复发率(47.5%)、B组复发率(61.53%)(<0.01)。结论:单纯性翼状胬肉切除术、翼状胬肉切除术+锶-90照射术后复发率较高,但是翼状胬肉切除术+自体角膜缘干细胞移植术术后再次复发的比率较低,这种术式是一种有效控制翼状胬肉术后复发率的治疗措施,是翼状胬肉高发地区中低等级医院值得推广和应用的一种较理想的有效的治疗方法。

Objective:to observe the clinical curative effect of the excision of pterygium of 3 different treatment methods and compare the recurrence rate with the 3 different treatment methods.Methods:Fourty eyes from 32 patients with primary pterygia were treated by surgical excision and postoperative β-irradiation using strontium-90((90)Sr)(group A).Only treated by surgical excision were thirty-nine eyes from 31 patients(group B,the control group)and fourty eyes from 33 patients were treated by Pterygium excision combined with autologous limbal stem cell transplantation(group C). They were randomly divided into group A, B and C,2test was used to analysis the recurrence rate.Results:The evaluation standard of curative effect according to the curative effect of the grading standard of Prabhasawat after pterygium surgical excision,the efficacy evaluation performed under the slit lamp, and the 4th level was the true pterygium recurrence.There were nineteen eyes in group A recurrence(47.5%), twenty-four eyes in group B(61.53%),only three eyes in group C(7.5%).The recurrence rate of group C Significantly lower than the others group.The difference was statistically significant.Conclusion: The groups A,B has a higher recurrence rates, and the recurrence rate of group C Significantly lower than others group,so pterygium excision combined with autologous limbal stem cell transplantation was an ideal and effective method for the treatment of pterygium for the popularization and application of high incidence area of low grade hospitals.