CAJ | 학술논문

目的：探讨应用纤维蛋白胶联合绷带型角膜接触镜减轻翼状胬肉切除联合自体角膜缘干细胞移植术后疼痛的效果。 　　方法：对52例72眼行翼状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(纤维蛋白胶联合绷带型角膜接触镜组)28例38眼和对照组(缝线组)24例34眼。试验组及对照组给予常规20 g/L利多卡因浸润麻醉后进行翼状胬肉切除联合自体角膜缘干细胞移植术。试验组采用黏合剂将植片与植床进行粘贴,对照组采用10-0缝线缝合植片与植床。术毕,试验组角膜表面放置角膜接触镜,对照组不配戴角膜接触镜。主要术后观察患者的术后1,2,3,5,7 d疼痛评分。术后随访6mo,观察植床与植片的匹配程度及感染、复发、植片愈合不良、结膜下囊肿等并发症情况。 　　结果：试验组患者疼痛程度评分均较对照组显著降低(均为P=0.000)。观察期内,两组植床与植片均成功固定于巩膜表面,并全部成活,同时两组患者均未发生感染、复发、植片愈合不良、结膜下囊肿等并发症。 　　结论：联合运用纤维蛋白胶黏合剂粘及角膜接触镜,可明显减轻翼状胬肉术后的疼痛反应。
목적：탐토응용섬유단백효연합붕대형각막접촉경감경익상노육절제연합자체각막연간세포이식술후동통적효과。 　　방법：대52례72안행익상노육절제연합자체각막연간세포이식수술치료적초발성익상노육환자,수궤분위시험조(섬유단백효연합붕대형각막접촉경조)28례38안화대조조(봉선조)24례34안。시험조급대조조급여상규20 g/L리다잡인침윤마취후진행익상노육절제연합자체각막연간세포이식술。시험조채용점합제장식편여식상진행점첩,대조조채용10-0봉선봉합식편여식상。술필,시험조각막표면방치각막접촉경,대조조불배대각막접촉경。주요술후관찰환자적술후1,2,3,5,7 d동통평분。술후수방6mo,관찰식상여식편적필배정도급감염、복발、식편유합불량、결막하낭종등병발증정황。 　　결과：시험조환자동통정도평분균교대조조현저강저(균위P=0.000)。관찰기내,량조식상여식편균성공고정우공막표면,병전부성활,동시량조환자균미발생감염、복발、식편유합불량、결막하낭종등병발증。 　　결론：연합운용섬유단백효점합제점급각막접촉경,가명현감경익상노육술후적동통반응。
AIM:To explore the efficacy of fibrin glue with bandage contact lens for pain relief after pterygium surgery performed with limbal autograft transplantation. METHODS:A prospective clinical trial was carried out in 52 patients ( 72 eyes ) operated for primary nasal pterygium. All patients were randomly divided into the fibrin glue with bandage contact lens group ( experimental group, 28 cases, 38 eyes ) and suture group ( control group, 24 cases, 34 eyes) . Autologous limbal graft taken from the superotemporal limbus was used to cover the sclera after pterygium excision under local anesthesia with 20g/L lidocaine. In experimental group, the transplant was attached to the sclera with fibrin tissue adhesive and in control group with 10 - 0 Virgin silk sutures. Experimental group weared bandage contact lens after surgery while the control group did not. The degree of pain after surgery was evaluated at 1, 2, 3, 5 and 7d after surgery. Follow-up was 6mo, matching degree of graft and complication such as infection, relapse, implant healing badness and subconjunctival cyst were mainly observed and recorded. RESULTS: The pain index scores of the experimental group were significantly less than those of control group (all P = 0. 000). In observation period, all conjunctival autografts in both groups were successfully attached and were intact without falling off, dissolution or recurrence and there were no complications such as infection, relapse, implant healing badness and subconjunctival cyst. CONCLUSION: Fibrin glue with bandage contact lens could significantly release pain response afterpterygium excision surgery.