胬肉切除联合结膜瓣移植术在翼状胬肉治疗中的临床价值

Clinical value of pterygium excision combined with conjunctival flap transplantation in treatment of pterygium

  • 摘要:
    目的 探讨胬肉切除联合结膜瓣移植术在翼状胬肉治疗中的临床价值。
    方法 选取60例(72眼)翼状胬肉患者作为研究对象,将采用胬肉切除联合结膜瓣移植术治疗的30例(36眼)患者纳入观察组,将采用胬肉切除联合羊膜移植术治疗的30例(36眼)患者纳入对照组。术前和术后3、6个月,分别评估2组患者的泪膜功能参数,包括基础泪液分泌长度(5 min)、泪膜破裂时间和荧光素染色评分。术后第1、3、5、14天,分别评估2组患者的眼部舒适度。术后随访1年,比较2组患者的疗效和复发情况。
    结果 术前, 2组患者基础泪液分泌长度、泪膜破裂时间、荧光素染色评分比较,差异无统计学意义(P>0.05); 术后3、6个月,观察组泪膜破裂时间长于对照组,荧光素染色评分低于对照组,差异有统计学意义(P<0.05)。术后第1、3、5、14天,观察组眼部舒适度总评分均低于对照组,差异有统计学意义(P<0.05)。术后1年, 2组患者疗效和复发率比较,差异无统计学意义(P<0.05)。
    结论 胬肉切除联合结膜瓣移植术应用于翼状胬肉的治疗中疗效确切,且无严重并发症发生。

     

    Abstract:
    Objective To investigate the clinical value of pterygium excision combined with conjunctival flap transplantation in treatment of pterygium.
    Methods A total of 60 patients (72 eyes) with pterygium were selected as research objects, 30 patients (36 eyes) treated with pterygium excision combined with conjunctival flap transplantation were included in observation group, and 30 patients (36 eyes) treated with pterygium excision combined with amniotic membrane transplantation were included in control group. The tear film function parameters, including basal tear secretion length (5 min), tear film rupture time and fluorescein staining score were evaluated before operation and at 3 and 6 months after operation. On 1st, 3rd, 5th and 14th postoperative day, the ocular comfort of patients in the two groups were evaluated respectively. After 1 year of follow-up, the efficacy and recurrence of the two groups were compared.
    Results There were no significant differences in the preoperative basal tear secretion length, tear film break-up time and fluorescein staining score between the two groups(P > 0.05). The tear film break-up time of the observation group was longer than that of the control group at 3 and 6 months after the operation, and the fluorescein staining score was lower than that in the control group (P < 0.05). The total scores of eye comfort on the 1st, 3rd, 5th, and 14th day after operation in the observation group were significantly lower than that in the control group (P < 0.05). There were no significant differences in curative effect and recurrence rate between the two groups at one year after operation (P < 0.05).
    Conclusion Pterygium excision combined with conjunctival flap transplantation is effective in treatment of pterygium, and no serious complications occur.

     

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