【摘要】 目的:评价采用无缝线粘贴法应用于翼状胬肉手术的疗效。方法:对57例75眼鼻侧原发性翼状胬肉患者,随机分成4组,A、B组为新方法无缝线粘贴法,粘合剂为生物粘合剂纤维蛋白粘合剂,其中A组13例(16眼)采用逆向翼状胬肉切除+角膜缘干细胞移植,结膜瓣采用纤维蛋白粘合剂粘贴。B组12例(15眼)组采用逆向翼状胬肉切除+生物羊膜移植,生物羊膜采用纤维蛋白粘合剂粘贴。C、D组为常规缝合组,其中C组13例(18眼)采用逆向翼状胬肉切除+生物羊膜移植,生物羊膜采用10-0尼龙线缝合。D组19例(26眼)采用逆向翼状胬肉切除+角膜缘干细胞移植,结膜瓣采用10-0尼龙线缝合。对手术时间、疼痛感觉、复发率、并发症等指标进行比较分析。结果:手术时间:A组与B组比较无显著性差异(P>0.05);A组与C组、D组;B组与C组、D组比较具有显著差异性(P<0.05)。C组与D组无显著差异性(P>0.05)。疼痛评估:A、B组比较无显著性差异(P>0.05),A组与C组、D组;B组与C组、D组具有显著差异性(P<0.05);C组与D组无显著差异性(P>0.05)。A组16眼术后复发1眼,复发率为6.3%;B组15眼术后复发2眼,复发率为13.3%;C组18眼术后复发3眼,复发率为16.7%;D组26眼术后复发2眼,复发率为7.7%;各组间无显著差异性。结论:在翼状胬肉手术中,采用逆向翼状胬肉切除+角膜缘干细胞移植,结膜瓣采用纤维蛋白粘合剂粘贴,可减轻患者疼痛,减轻炎症反应,缩短手术时间,提高手术质量,降低复发率。更多还原

【Abstract】 Objective:To observe the therapeutic effects in treatment of pyerygium of no suture paste. Method:Retrospective study The study included 75 eyes of 57 patients operated for primary nasal pterygium between 2007/9 and 2009 /6 and followed for≥3 months. randomly divided into four groups: group A and group B used new method of no suture paste: bond use biotic bond of fibrin tissue adhesive,reversectomy of pterygium with Limbal stem cells graft autograft with conntive-conjunctive transplantation (group A, 16 eyes): conntive-conjunctive paste use fibrin tissue adhesive;reversectomy of pterygium with biotic amniotic membrane transplantation (group B, 15 eyes); biotic amniotic membrane paste used fibrin tissue adhesive. group C and group D used usually method of suture : reversectomy of pterygium with biotic amniotic membrane transplantation (group C, 18 eyes); biotic amniotic membrane suture use 10-0 nylon suture.reversectomy of pterygium with Limbal stem cells graft autograft with conntive-conjunctive transplantation (group D, 26 eyes): conntive-conjunctive suture use 10-0 nylon suture; Main outcome measures:average surgery time, average pain, recurrence rate and complications.Result: The average surgery time: The differences were not statisticallly significant between the group A and B(P>0.05); The differences were statisticallly significant between the A and group C,D(P<0.05); The differences were statisticallly significant between group B and C,D(P<0.05); The differences were not statistical significant between group C and D (P>0.05 ).The average pain: The differences were not statistical significant between group A and B (P>0.05); The differences were statistical significant between group A and C,D(P<0.05); The differences were statistical significant between group B and C,D(P<0.05); The differences were not statistical significant between group C and D(P>0.05 ). The recurrence rate: 6.3% (1of 16 eyes were recurred) in group A; 13.3% (2 of 15 eyes were recurred) in group B; 16.7% (3 of 18eyes were recurred) in group C; 7.7% (3 of 26 eyes were recurred) in group D. The differences were not statisticallly significant among four groups (P>0.05 ).Conclusion:Using a fibrin tissue adhesive instead of sutures when attaching the conjunctival transplant with reversectomy of pterygium with Limbal stem cells graft autograft in primary pterygium surgery results in alleviating pain of patients, reducing inglammation of reaction, improving surgery quality, shortening surgery time, reducing recurrence rate.更多还原