CAJ | 학술논문

目的：探讨奥布卡因表面麻醉及利多卡因局部麻醉下应用纤维蛋白胶在胬肉切除联合自体角膜缘干细胞移植术中的效果。 　　方法：对55例60眼行胬肉切除联合自体角膜缘干细胞移植手术治疗的初发性翼状胬肉患者,随机分为试验组(表面麻醉组)27例30眼和对照组(局部麻醉组)28例30眼。试验组给予常规奥布卡因表面麻醉后进行胬肉切除联合自体角膜缘干细胞移植术；对照组给予20 g/L利多卡因局部麻醉试验后进行胬肉切除联合自体角膜缘干细胞移植术。试验组及对照组均采用黏合剂将植片与植床进行粘贴(黏合剂为凝血酶溶液及含有因子峪和抑肽酶的纤维蛋白溶液)。术后随访6mo,主要观察手术时间,植床与植片的匹配程度及术中与术后患者的疼痛评分。 　　结果：试验组手术时间相对较短,差异有统计学意义(P=0.008),试验组植床与植片匹配度(93%)优于对照组(83%),具有统计学差异(P<0.05)。 　　结论：奥布卡因表面麻醉下使用纤维蛋白胶黏合剂完全能满足胬肉切除联合自体角膜缘干细胞移植术的要求,且能使植床与植片更好匹配,缩短了手术时间。
목적：탐토오포잡인표면마취급리다잡인국부마취하응용섬유단백효재노육절제연합자체각막연간세포이식술중적효과。 　　방법：대55례60안행노육절제연합자체각막연간세포이식수술치료적초발성익상노육환자,수궤분위시험조(표면마취조)27례30안화대조조(국부마취조)28례30안。시험조급여상규오포잡인표면마취후진행노육절제연합자체각막연간세포이식술；대조조급여20 g/L리다잡인국부마취시험후진행노육절제연합자체각막연간세포이식술。시험조급대조조균채용점합제장식편여식상진행점첩(점합제위응혈매용액급함유인자욕화억태매적섬유단백용액)。술후수방6mo,주요관찰수술시간,식상여식편적필배정도급술중여술후환자적동통평분。 　　결과：시험조수술시간상대교단,차이유통계학의의(P=0.008),시험조식상여식편필배도(93%)우우대조조(83%),구유통계학차이(P<0.05)。 　　결론：오포잡인표면마취하사용섬유단백효점합제완전능만족노육절제연합자체각막연간세포이식술적요구,차능사식상여식편경호필배,축단료수술시간。
AIM:To compare the efficiency of fibrin glue to suture technique in pterygium surgery performed with limbal autograft under different methods of anesthesia. METHODS: A prospective randomised clinical trial was carried out in 60 eyes of 55 patients operated for primary nasal pterygium, which were divided into two groups randomly: experimental group ( 30 eyes in 27 patients ) was under surface anesthesia ( oxybuprocaine ) and control group ( 30 eyes in 28 patients ) was under local anesthesia ( 20g/L lidocaine ). Autologous limbal graft taken from the superotemporal limbus was used to cover the sclera by a fibrin tissue adhesive after pterygium excision. Patients were followed up at least for 6mo. Time of operation, matching degree of graft and VAS score were mainly observed and recorded. RESULTS: In experimental group the average surgery time was shorter (P=0. 008) and matching degree of graft ( 93%) was better than control group ( 83%) , the differences had statistical significance(P<0.05). CONCLUSION: The surface anesthesia is enough when using fibrin glue for graft fixation in pterygium surgery, which will shorten surgery time and get better matching degree of graft.