外用冻干人纤维蛋白粘合剂固定植片治疗原发性翼状胬肉的效果分析(1)
摘 要：目的 观察外用冻干人纤维蛋白粘合剂固定植片治疗原发性翼状胬肉的临床效果，评价外用冻干人纤维蛋白粘合剂固定植片的安全性和有效性。方法 回顾性分析行自体角膜缘干细胞移植术的原发性翼状胬肉患者73例(106眼)的病历资料，所有患者术中均应用外用冻干人纤维蛋白粘合剂固定植片，术后随访6～24个月，观察术后视力、移植片存活及复发率等情况。结果 术后4 w，视力提高34眼，不变72眼，植片均存活，胬肉切除区角膜恢复透明者30眼，遗留角膜斑翳或角膜白斑者共76眼。随访期末，仅3眼复发，复发率2.83%，所有术眼均无眼压升高。结论 应用外用冻干人纤维蛋白粘合剂固定植片治疗原发性翼状胬肉效果确切，术后刺激症状轻，复发率低，安全有效。
关键词：翼状胬肉；自体角膜缘干细胞；纤维蛋白粘合剂；固定植片
中图分类号：R779.6 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.07.067
, 百拇医药
文章编号：1006-1959(2018)07-0186-03
Treatment of Primary Pterygium with Freeze-dried Human Fibrin Binder
WANG Juan
(Department of Ophthalmology，Jinghai District Hospital，Tianjin 301600，China)
Abstract：Objective To observe the clinical effect of freeze-dried human fibrin binder in the treatment of primary pterygium，and to evaluate the safety and efficacy of freeze-dried human fibrin binder for the treatment of primary pterygium.Methods The medical records of 73 cases(106 eyes)of primary pterygium with limbal stem cell autograft transplantation were retrospectively analyzed.All the patients were treated with freeze-dried human fibrin binder during operation and followed up for 6～24 months.Visual acuity，survival rate and recurrence rate were observed.Results The visual acuity was improved in 34 eyes and unchanged in 72 eyes at 4 w after operation.All the grafts survived.The corneal transparency was restored in 30 eyes in the pterygium excision area and 76 eyes in the left corneal pannus or corneal white spot.At the end of follow-up，only 3 eyes recurred and the recurrence rate was 2.83%.No elevation of intraocular pressure was found in all eyes.Conclusion The external application of freeze-dried human fibrin binder is effective in the treatment of primary pterygium.The postoperative irritation symptom is mild，the recurrence rate is low，and it is safe and effective.
, 百拇医药
Key words：Pterygium；Autologous limbal stem cells；Fibrin binder；Fixation graft
翼狀胬肉(pterygium)是常见的眼表疾病，主要治疗方法是手术切除。有研究表明[1]翼状胬肉切除联合自体角膜缘干细胞移植术术后远期复发率(10.34%)明显低于巩膜暴露术及羊膜移植术。自体角膜缘干细胞移植术中植片固定传统方法为10-0尼龙线或7-0、8-0可吸收线，但术后刺激症状多较明显。近年来，纤维蛋白粘合剂被应用于翼状胬肉手术中固定植片，其效果好，术后刺激症状轻，逐渐推广[2]。现对2014年12月～2017年2月于我院行翼状胬肉切除联合自体角膜缘干细胞移植术，术中应用外用冻干人纤维蛋白粘合剂的73例(106眼)患者的病历资料进行回顾性分析，报告如下。
1 资料与方法
1.1一般资料 回顾性分析2014年12月～2017年2月于天津市静海区医院进行翼状胬肉切除联合自体角膜缘干细胞移植术的患者73例(106眼)。其中男35例，女38例，年龄38～85岁。双眼发病者33例，单眼发病者40例。病程≤5年36例，5～10年11例，≥10年26例。主诉为眼红者43例，视物模糊4例，异物感3例，无症状23例。农民66例，退休工人7例。所有患者均进行裸眼视力、裂隙灯及眼压等眼科常规检查。排除胶原血管病、自身免疫性疾病、妊娠、眼干燥症、眼表急性炎症、睑球粘连及角膜缘部既往手术史者。翼状胬肉均为初发、鼻侧，头部顶端侵入角膜缘内2～7 mm，其中≤3 mm共57眼，3～5 mm共26眼，≥5 mm共23眼。所有患者术前签订手术同意书及治疗方案选择告知书，所有患者均自愿选择外用冻干人纤维蛋白粘合剂固定植片。, http://www.100md.com(王娟)
关键词：翼状胬肉；自体角膜缘干细胞；纤维蛋白粘合剂；固定植片
中图分类号：R779.6 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.07.067
, 百拇医药
文章编号：1006-1959(2018)07-0186-03
Treatment of Primary Pterygium with Freeze-dried Human Fibrin Binder
WANG Juan
(Department of Ophthalmology，Jinghai District Hospital，Tianjin 301600，China)
Abstract：Objective To observe the clinical effect of freeze-dried human fibrin binder in the treatment of primary pterygium，and to evaluate the safety and efficacy of freeze-dried human fibrin binder for the treatment of primary pterygium.Methods The medical records of 73 cases(106 eyes)of primary pterygium with limbal stem cell autograft transplantation were retrospectively analyzed.All the patients were treated with freeze-dried human fibrin binder during operation and followed up for 6～24 months.Visual acuity，survival rate and recurrence rate were observed.Results The visual acuity was improved in 34 eyes and unchanged in 72 eyes at 4 w after operation.All the grafts survived.The corneal transparency was restored in 30 eyes in the pterygium excision area and 76 eyes in the left corneal pannus or corneal white spot.At the end of follow-up，only 3 eyes recurred and the recurrence rate was 2.83%.No elevation of intraocular pressure was found in all eyes.Conclusion The external application of freeze-dried human fibrin binder is effective in the treatment of primary pterygium.The postoperative irritation symptom is mild，the recurrence rate is low，and it is safe and effective.
, 百拇医药
Key words：Pterygium；Autologous limbal stem cells；Fibrin binder；Fixation graft
翼狀胬肉(pterygium)是常见的眼表疾病，主要治疗方法是手术切除。有研究表明[1]翼状胬肉切除联合自体角膜缘干细胞移植术术后远期复发率(10.34%)明显低于巩膜暴露术及羊膜移植术。自体角膜缘干细胞移植术中植片固定传统方法为10-0尼龙线或7-0、8-0可吸收线，但术后刺激症状多较明显。近年来，纤维蛋白粘合剂被应用于翼状胬肉手术中固定植片，其效果好，术后刺激症状轻，逐渐推广[2]。现对2014年12月～2017年2月于我院行翼状胬肉切除联合自体角膜缘干细胞移植术，术中应用外用冻干人纤维蛋白粘合剂的73例(106眼)患者的病历资料进行回顾性分析，报告如下。
1 资料与方法
1.1一般资料 回顾性分析2014年12月～2017年2月于天津市静海区医院进行翼状胬肉切除联合自体角膜缘干细胞移植术的患者73例(106眼)。其中男35例，女38例，年龄38～85岁。双眼发病者33例，单眼发病者40例。病程≤5年36例，5～10年11例，≥10年26例。主诉为眼红者43例，视物模糊4例，异物感3例，无症状23例。农民66例，退休工人7例。所有患者均进行裸眼视力、裂隙灯及眼压等眼科常规检查。排除胶原血管病、自身免疫性疾病、妊娠、眼干燥症、眼表急性炎症、睑球粘连及角膜缘部既往手术史者。翼状胬肉均为初发、鼻侧，头部顶端侵入角膜缘内2～7 mm，其中≤3 mm共57眼，3～5 mm共26眼，≥5 mm共23眼。所有患者术前签订手术同意书及治疗方案选择告知书，所有患者均自愿选择外用冻干人纤维蛋白粘合剂固定植片。, http://www.100md.com(王娟)