手术切除联合角膜缘干细胞移植治疗翼状胬肉的临床价值评价

任旭岗

摘要：目的：研究手术切除联合角膜缘干细胞移植治疗翼状胬肉的临床价值。方法：本次选择对象为翼状胬肉患者，时间在2017年12月直至2018年8月之间，根据电脑随机分配的原则将80例翼状胬肉患者分为两组，其中包括对照组和观察组，分别行手术切除治疗;手术切除联合角膜缘干细胞移植治疗，对比其两组手术情况、视力和散光程度、治愈率和复发率。结果：观察组翼状胬肉患者角膜上皮修复时间2.13±0.32d、不适症状持续时间3.61±1.24d、住院时间7.13±1.15d均短于对照组，结膜充血率12.50%低于对照组，差异有统计学意义（P<0.05）。治疗后观察组翼状胬肉患者视力1.25±0.25°、散光程度0.41±0.02°，优于对照组，差异有统计学意义，P<0.05。观察组翼状胬肉患者治愈率、复发率与对照组相比，差异有统计学意义，P<0.05。结论：手术切除联合角膜缘干细胞移植治疗翼状胬肉效果显著，同时能够改善患者视力水平，值得研究。

关键词：手术切除;角膜缘干细胞移植;治疗;翼状胬肉

Clinical value of surgical excision combined with limbal stem cell transplantation for pterygium

[abstract] objective：to study the clinical value of surgical resection combined with limbal stem cell transplantation for pterygium. Methods：this study selected pterygium patients between December 2017 and August 2018. 80 pterygium patients were divided into two groups according to the principle of random allocation by computer，including the control group and the observation group，and were treated with surgical resection. Surgical excision combined with corneal limbal stem cell transplantation was performed to compare the operative status，visual acuity and astigmatism，cure rate and recurrence rate of the two groups. Results：corneal epithelial repair time of pterygium patients in the observation group was 2.13 + 0.32d，duration of discomfort symptoms was 3.61 + 1.24d，and hospitalization time was 7.13 + 1.15d shorter than the control group，conjunctival congestion rate was 12.50% lower than the control group，and the difference was statistically significant（P<0.05）. Observation group after treatment of pterygium patients visual acuity 1.25 + / - 0.25 °，degree of astigmatism 0.41 + / - 0.02 °，is better than that of control group，the difference was statistically significant，P < 0.05）. Compared with the control group，the cure rate and recurrence rate of pterygium in the observation group were statistically significant，P < 0.05. Conclusion：surgical excision combined with corneal limbal stem cell transplantation is effective for pterygium，and can improve the visual acuity of patients.

Keywords：surgical excision;Limbal stem cell transplantation;Treatment;pterygium

在臨床眼科疾病中，翼状胬肉十分多见，其在亚热带和热带地区发生率较高，主要以50岁以上人群较为多见。该疾病的发病机制主要是由于外界刺激所致的成纤维细胞异常增殖和眼睛新血管生成，翼状胬肉不仅对外观造成严重影响，同时易导致其出现角膜散光，使其瞳孔区被遮挡进而对视力造成影响，病情严重还可发生眼球运动障碍[1]。目前临床对于该类疾病通常选择手术治疗，但传统手术切除易增加手术风险，且术后复发率较高，易导致患者角膜创面愈合时残留瘢痕，进而对视力恢复造成影响。随着我国微创技术的不断提高，角膜缘干细胞移植在临床使用率逐渐升高，现已成为治疗翼状胬肉的首选方式[2]。本次研究对两组翼状胬肉患者不同治疗情况进行分析，具体内容见下。

1.资料/方法