CAJ | 학술논문

目的观察贝伐珠单抗对翼状胬肉切除联合角膜缘干细胞移植术后复发的影响.方法回顾性分析收治的单纯翼状胬肉75例(99眼)患者的治疗资料,根据用药不同,分为A组,即采用在翼状胬肉切除联合角膜缘干细胞移植术的基础上加用贝伐珠单抗；B组,在翼状胬肉切除联合角膜缘干细胞移植术基础上加用丝裂霉素C；C组,单纯采用翼状胬肉切除联合角膜缘干细胞移植术.术后随访3个月,比较治疗效果、复发情况.结果 A组复发4例(12.1％),B组复发5例(15.2％),C组复发15例(45.5％)；A组与B组复发率差异无统计学意义(x2 =2.117,P＞0.05),B组与C组复发率差异有统计学意义(x2=3.930,P＜0.05),A组与C组复发率差异有统计学意义(x2 =4.455,P＜0.05)；三组复发率差异有统计学意义(F=12.267,P＜0.05)；所有患者术后1周内有不同程度的眼痛、畏光、流泪,1周后消失；B组有2例术后发现角巩膜缘出现浅层巩膜坏死、浅层点状角膜炎.A组平均5.9d拆线,B组为7.0d拆线,C组为7.5d拆线.结论贝伐珠单抗能有效减少翼状胬肉切除联合角膜缘干细胞移植术后复发,且并发症少.
목적 관찰패벌주단항대익상노육절제연합각막연간세포이식술후복발적영향.방법 회고성분석수치적단순익상노육75례(99안)환자적치료자료,근거용약불동,분위A조,즉채용재익상노육절제연합각막연간세포이식술적기출상가용패벌주단항；B조,재익상노육절제연합각막연간세포이식술기출상가용사렬매소C；C조,단순채용익상노육절제연합각막연간세포이식술.술후수방3개월,비교치료효과、복발정황.결과 A조복발4례(12.1％),B조복발5례(15.2％),C조복발15례(45.5％)；A조여B조복발솔차이무통계학의의(x2 =2.117,P＞0.05),B조여C조복발솔차이유통계학의의(x2=3.930,P＜0.05),A조여C조복발솔차이유통계학의의(x2 =4.455,P＜0.05)；삼조복발솔차이유통계학의의(F=12.267,P＜0.05)；소유환자술후1주내유불동정도적안통、외광、류루,1주후소실；B조유2례술후발현각공막연출현천층공막배사、천층점상각막염.A조평균5.9d탁선,B조위7.0d탁선,C조위7.5d탁선.결론 패벌주단항능유효감소익상노육절제연합각막연간세포이식술후복발,차병발증소.
Objective To explore the clinical effents of bevacizumab on the recrudescence of the limbal corneal epithelial cell auto-graft transplantation in treating patients with pterygium.Methods The clinical data of 75 cases(99 eyes) with pterygium were retraspectively reviewed,and they were divided into 3 groups by different conservative treatment.A group:the limbal corneal epithelial cell auto-graft transplantation combined with bevacizumab.B group:the limbal corneal epithelial cell auto-graft transplantation combined with MMC.C group:the limbal corneal epithelial cell auto-graft transplantation.After follow-up for 3 months,the curative effect and recurrence were compared between the two groups.Results The recurrence of three groups was significantly different( x2 =12.267,P ＜ 0.05 ).The reccurrence rate of A,B,C group were 12.1％,15.2％,45.5％.The recurrence rate of A group and B group wasn't significantly different(x2 =2.117,P ＞0.05).The recurrence rate of B group and C group wasn't statistically different( x2 --3.930,P ＜ 0.05 ).The recurrence rate of A group and C group was significantly different( x2 =4.155,P ＜ 0.05 ).After 1 week,all patients had different degrees of eye pain,photophobia or tearing,and disappeared after 1 week;2 patients in group B found that limbal shallow scleral necrosis,superficial punctate keratitis.The average time of removal of stitches in group A was 5.9d,group B was 7.0d and group C was 7.5d.Conclusion Bevacizumab could obviously reduce the recrudescence of the limbal corneal epithelial cell auto-graft transplantation in treating patients with pterygium.It was safe with less complications and good prognosis.It was worthy for being widely used in treatment of pterygium.