目的:探讨不同球结膜移植术及术后干预对翼状胬肉患者舒适度及疗效的影响.方法:选取2017年1月—2019年12月样本医院收治的200例(200眼)翼状胬肉患者作为研究对象,按随机数表法分为A、B、C、D 4组,每组50例(50眼).A、B组采用切除术联合自体游离结膜瓣移植术,C、D组采用切除术联合角膜缘干细胞移植,B、D组术后佩戴角膜绷带镜.观察对比4组患者术后眼部不适、视力、角膜上皮愈合时间、治愈率及复发率情况.结果:4组患者术后均出现不同程度的眼部不适,3 d后缓解,2周后基本消失.术后1 d、3d、7d B组患者眼部不适较A组轻,D组患者眼部不适较C组轻,而A组与C组、B组与D组之间比较,差异无统计学意义(F=0.083,P＞0.05);术后1 d、3 d 4组患者的裸眼视力均有不同程度的下降.术后1d、3 d B组患者视力较A组高,D组患者视力较C组高,差异有统计学意义(F=3.026、3.088,P＜0.05);4组患者术后角膜上皮愈合约需4～6 d,B组角膜上皮愈合时间较A组短,D组较C组短,差异有统计学意义(F=35.800,P＜0.05);4组患者术后治愈率和术后翼状胬肉复发情况比较,差异无统计学意义(χ2=0.632、1.031,P＞0.05).结论:切除术联合角膜缘干细胞移植对翼状胬肉患者治疗效果显著,复发率较低.佩戴角膜绷带镜可减轻术后眼部不适,有利于角膜上皮愈合和早期视力的稳定,对翼状胬肉的治疗具有积极意义.
Effect of Different Conjunctival Transplantation and Postoperative Intervention on Comfort and Efficacy of Patients with Pterygium
Objective:To investigate the effect of different bulbar conjunctiva transplantation and postoperative intervention on the comfort and efficacy of patients with pterygium.Methods:A total of 200 patients(200 eyes)with pterygium who were admitted to the hospital from January 2017 to December 2019 were selected as the research objects,and they were divided into 4 groups according to the random number table method,with 50 cases(50 eyes)in each group.Groups A and B were treated with excision combined with autologous free conjunctival flap transplantation,group C and D were treated with excision combined with limbal stem cell transplantation,and group B and D wore corneal bandage lenses after surgery.The postoperative eye discomfort,visual acuity,corneal epithelial healing time,cure rate and recurrence rate of the four groups were observed and compared.Results:The 4 groups of patients had different degrees of eye discomfort after operation,which was relieved after 3 days and basically disappeared after 2 weeks.1,3 and 7 days after operation,the eye discomfort of group B was lighter than that of group A,and the eye discomfort of group D was lighter than that of group C,and there was no statistically significant difference between group A and group C,and group B and group D(P＞0.05).On the 1 and 3 days after operation,the uncorrected visual acuity of 4 groups decreased to varying degrees,the visual acuity improved 2 weeks after the operation,and the visual acuity was stable 12 weeks after operation(P＜0.05).1 and 3 day after operation,the visual acuity of group B was higher than that of group A,and the visual acuity of group D was higher than that of group C(P＜0.05),but there was no significant difference between group A and group C,group B and group D(P＞0.05).The corneal epithelial healing time of the four groups of patients was about 4～6 days.The corneal epithelial healing time of group B was shorter than that of group A,and that of group D was shorter than that of group C(P＜0.05).The differences between group A and group C,group B and group D were all not statistically significant(P＞0.05).Conclusion:Resection combined with limbal stem cell transplantation is effective in the treatment of patients with pterygium,and the recurrence rate is low.Wearing a corneal bandage lens can reduce postoperative eye discomfort,facilitate corneal epithelial healing and early visual acuity stability,and has positive significance for the treatment of pterygium.
万方数据
维普
