【摘要】 背景:翼状胬肉治疗方法以手术为主,手术方法多种多样。目的:观察自行设计的翼状胬肉逆行切除加相邻带干细胞自体结膜转位术对翼状胬肉的治疗效果。设计:病例随访观察。单位:中国医科大学附属第四医院眼科。对象:选择2003-05/2006-05就诊于中国医科大学附属第四医院的翼状胬肉患者50例(60眼),患者均同意接受手术治疗并配合随访观察,且得到医院伦理道德委员会批准。方法:逆行将翼状胬肉头部自角膜上分离,向泪阜方向及上下方向钝性分离结膜及其下方增生变性组织,直至近半月皱襞处,全部切除胬肉。转位相邻带干细胞的自体结膜于巩膜裸露区。术后定期随访。主要观察指标:①术后角膜上皮、结膜上皮的愈合时间。②翼状胬肉的复发率。结果:①50例翼状胬肉患者(60眼)的的角膜上皮、结膜上皮缺损区均在术后一两天内愈合。②拆线后随访8～16个月,其中8～12个月26眼,13～16个月34眼,平均12个月。58眼痊愈,2眼复发。结论:翼状胬肉逆行切除加相邻带干细胞自体结膜转位术简单易操作,并可较大程度地降低胬肉术后复发率。更多还原

【Abstract】 BACKGROUND:Surgery is the common therapy for pterygium,and there are several surgical management techniques. OBJECTIVE:To clinically assess the effect of pterygium retro-resection followed by the transposition of conjunctival autograft rich in stem cells. DESIGN:Follow-up of the cases. SETTING:Department of Ophthalmology,the Fourth Affiliated Hospital of China Medical University. PARTICIPANTS:Fifty patients(60 eyes)with pterygium,who were treated in the Fourth Affiliated Hospital of China Medical University from May 2003 to May 2006,were selected.All patients agreed to receive the treatment and participate in the follow-up.The trial was permitted by the Hospital Ethics Committee. METHODS:The head of pterygium was separated from cornea,including the conjunctiva and the underlying proliferating tissue towards lacrimal caruncle until plica semilunafis.The pterygium was totally removed.The adjacent healthy conjunctiva harboring stem cells was transposed to cover the naked sclera.The patients were evaluated following the operation. MAIN OUTCOME MEASURES:①Epithelization of cornea and conjunctiva;②reoccurrence of pterygium. RESULTS:①The epithelium of cornea and conjunctiva in all cases(60 eyes)healed within 1-2 days after the operation.②The patients were followed for 8-16 months after the sutures were removed.Out of the total of 60 eyes,26 were followed for 8-12 months and 34 for 13-16 months.The average length of observation was 12 months.Fifty-eight eyes healed completely,and reoccurrence took place in 2 cases. CONCLUSION:Pterygium resection followed by the transposition of adjacent conjunctival autograft harboring stem cells is easy to perform and effective to reduce the recurrence of the lesion.更多还原