J4 ›› 2016, Vol. 15 ›› Issue (2): 41-44.

• 临床医学 • 上一篇    下一篇

生物羊膜移植治疗翼状胬肉的临床疗效观察

  

  1. (南华县人民医院,云南南华 675200)
  • 收稿日期:2015-03-10 出版日期:2016-02-15 发布日期:2016-02-15
  • 作者简介:朱洪芬,主治医师,主要从事细菌的耐药性及耐药机制研究.

Clinical Efficacy of Amniotic Membrane Transplantation Treating Pterygium

  1. (People's Hospital of Nanhua County, Nanhua, Yunnan 675200, China)
  • Received:2015-03-10 Online:2016-02-15 Published:2016-02-15

摘要:

目的:评价生物羊膜移植和自体角膜缘干细胞移植治疗翼状胬肉的临床疗效。方法:把240例245眼住院治疗的翼状
胬肉病人随机分为治疗组及对照组。治疗组采用翼状胬肉切除联合生物羊膜移植术;对照组采用翼状胬肉切除联合自体角膜
缘干细胞移植术。治疗组120例122眼,对照组120例123眼。观察两组术后眼表情况、角结膜上皮愈合情况、患者自觉症状、复发率以及视力变化。结果:术后1周眼表情况评估,治疗组优良115眼,占94.3%。对照组优良95眼,占77.2%。术后观察角结膜上皮愈合时间,治疗组为3~7 d,3 d愈合率占73.1%,对照组为3~10 d,3 d愈合率占53.6%。治疗组愈合时间明显短于对照组;术后1周患者自觉症状治疗组好于对照组;术后随访24月,治疗组复发率为7%,对照组为13%。结论:翼状胬肉切除联合生物羊膜移植治疗翼状胬肉,术后眼表情况、患者自觉症状优于自体角膜缘干细胞移植术;24月随访总复发率显著低于对照组,经SPSS12.0软件处理,自由度3,χ2 =98.45,P<0.01,差异有统计学意义。两组视力提高不明显,部分提高原因主要是消除了翼状胬肉导致的角膜散光,但经SPSS12.0软件处理,自由度2,χ2 =1.66,P>0.05,差异无统计学意义。

关键词: 生物羊膜, 自体角膜缘干细胞, 翼状胬肉, 移植

Abstract:

Objective: To evaluate clinical efficacy of biological amniotic membrane transplantation and autologous limbal stem cell
transplantation in the treatment of pterygium. Methods: 245 eyes in 240 cases of pterygium hospitalized were randomly divided into treatment group and control group(120 cases in each group). The treatment group received pterygium resection and biological amniotic membrane transplantation; the control group received pterygium excision combined with autologous limbal stem cell transplantation.There were 122 eyes in the treatment group, 123 eyes in the control group. Postoperative ocular conditions, corneal and conjunctival epithelial healing, patients with symptoms, relapse rates, and changes in vision were observed. Results: After a week of ocular surface assessment, 115 eyes were fine in the treatment group, accounting for 94.3%. 95 fine in the control group(77.2%). The postoperative corneal and conjunctival epithelial healing time for the treatment group was 3 to 7 days, three-day healing rate was 73.1%. The healing time for the control group was 3 to 10 days and the three-day healing rate was 53.6%. The time of the treatmentment group was significantly shorter than that of the control group; patient's rational symptom a week after was better in the treatment group than the
control group. In the 24-month postoperative follow-up, the recurrence rate was 7% in the treatment group, the control was 13%.Conclusion: The postoperative ocular conditions and the rational symptoms of pterygium resection and biological amniotic membrane transplantation were better than the limbal stem cell transplantation. The overall 24-month follow-up recurrence rate was significantly lower than the control group. Disposed with SPSS12.0 software, D/F was 3, χ2 =98.45, the difference was significant(P<0.01). Obvious visual acuity improvement was rarely found, few was improved due to the elimination of the cause of pterygium corneal astigmatism, but after SPSS12.0 software processing, the degree of freedom was 2, χ2 =1.66, with no significant difference(P>0.05).

Key words: biological amnion, limbal stem cells, pterygium, transplantation

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