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扩大切除联合绷带式角膜接触镜治疗复发性翼状胬肉效果观察(1)
http://www.100md.com 2017年11月15日 中国现代医生 2017年第32期
     [摘要] 目的 观察扩大切除联合绷带式角膜接触镜治疗复发性翼状胬肉的临床疗效。 方法 采用随机数字表法将我院2015年1月~2017年1月收治的30例复发性翼状胬肉患者分为A组及B组,各15例,A组采取传统翼状胬肉切除+自体角膜缘干细胞移植术治疗,B组采取翼状胬肉扩大切除+自体角膜缘干细胞移植术+绷带式角膜接触镜治疗,对两组临床疗效进行观察和比较。 结果 术前两组眼部症状评分无明显差异,术后l d、3 d、5 d进行比较,B组优于A组,差异有统计学意义(P<0.05);术后随访6个月,A组复发率为20.00%,B组复发率为6.67%,差异有统计学意义(P<0.05)。 结论 在复发性翼状胬肉的治疗工作中扩大切除联合绷带式角膜接触镜取得的治疗效果更佳,可作为临床优选治疗方案加以推广使用。

    [关键词] 扩大切除术;绷带式角膜接触镜;复发性翼状胬肉;眼部症状评分;复发率

    [中图分类号] R779 [文献标识码] B [文章编号] 1673-9701(2017)32-0052-03

    [Abstract] Objective To observe the clinical effect of extended resection combined with bandage contact lenses in the treatment of recurrent pterygium. Methods A total of 30 patients with recurrent pterygium treated in our hospital from January 2015 to January 2017 were randomly divided into group A(n=15) and group B(n=15), according to random number table method. Group A received conventional pterygium excision combined with autologous limbal stem cell transplantation. Group B underwent pterygium extended resection combined with autologous limbal stem cell transplantation and bandage contact lenses therapy. The clinical efficacy between the two groups were observed and compared. Results There was no significant difference in the scores of ocular symptoms between the two groups before operation. The scores of ocular symptoms in group B at 1 d, 3 d and 5 d after operation were better than those in group A, and the differences were statistically significant(P<0.05). The patients were followed up for 6 months. The recurrence rate was 20.00% in group A and 6.67% in group B, and the difference was statistically significant(P<0.05). Conclusion The extended resection combined with bandage contact lenses has better treatment effect in the treatment of recurrent pterygium, which can be promoted as a preferred clinical treatment.

    [Key words] Extended resection; Bandage contact lenses; Recurrent pterygium; Eye symptom score; Relapse rate

    翼狀胬肉(pterygium)是当前眼科临床常见的病症类型,医学界认为该病症是由于外界刺激下局部球结膜纤维血管组织发生病变所致的一种慢性炎症型疾病,可侵犯角膜并累及单眼或双眼[1]。治疗该病症的方法多样,包括药物保守治疗、手术治疗、冷冻治疗、激光治疗等,虽可取得一定疗效但极容易复发。目前临床针对复发性翼状胬肉患者着重推荐手术治疗,尤其是随着医疗技术的快速发展,手术方案日益多样。鉴于此,本次研究围绕扩大切除联合绷带式角膜接触镜治疗复发性翼状胬肉展开分析,现报道如下。

    1 资料与方法

    1.1一般资料

    采用随机数字表法将我院2015年1月~2017年1月收治的30例复发性翼状胬肉患者分为A组及B组,各15例。A组中男9例、女6例;年龄44~69岁,平均(56.37±1.23)岁;眼别:左眼8例、右眼7例;翼状胬肉侵入角膜长度1.8~5.2 mm,平均(3.24±0.16)mm;症状表现:规则散光11例、眩光4例。B组中男8例、女7例;年龄45~69岁,平均(56.40±1.25)岁;眼别:左眼9例、右眼6例;翼状胬肉侵入角膜长度2.0~5.2 mm,平均(3.25±0.15)mm;症状表现:规则散光10例、眩光5例。纳入标准:(1)眼科常规检查确诊为复发性翼状胬肉者;(2)无翼状胬肉切除术、自体角膜缘干细胞移植术、绷带式角膜接触镜禁忌证者。排除标准:(1)严重精神障碍或认知功能障碍者;(2)术前合并眼部炎症性疾病者;(3)血液系统疾病或凝血功能障碍者。两组患者一般资料比较,差异无统计学意义。, 百拇医药(刘晶 袁思奇 谢招莲)
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