CAJ | 학술논문

目的比较翼状胬肉切除联合自体结膜移植和翼状胬肉切除联合羊膜移植两种不同手术方式对患者泪液功能的影响及其可能机制.方法选择2010年9月至2012年12月在宜昌市中心人民医院眼科住院的翼状胬肉患者80例80只眼,按随机数字表法分成两组,A组40例40只眼行翼状胬肉切除联合自体结膜瓣移植术,B组40例40只眼行翼状胬肉切除联合羊膜移植术,分别于术前和术后l、3个月检查泪膜破裂时间(BUT)、Schirmer Ⅰ试验并作统计学分析.结果 A、B两组中术后1、3个月均较术前BUT缩短、Schirmer Ⅰ减少,与术前比较差异有统计学意义(P＜0.05).A、B两组进行组间比较时,发现术后1、3个月时B组BUT较A组长,差异有统计学意义(P =0.014、0.027);术后1、3个月时B组Schirmer Ⅰ较A组多,差异无统计学意义(P＞0.05).结论翼状胬肉切除术后3个月内对泪膜功能有影响,术后3个月后泪膜分泌功能逐渐恢复.行翼状胬肉切除联合羊膜移植术后早期对泪膜功能的影响小于翼状胬肉切除联合自体结膜瓣移植术.
목적 비교익상노육절제연합자체결막이식화익상노육절제연합양막이식량충불동수술방식대환자루액공능적영향급기가능궤제.방법 선택2010년9월지2012년12월재의창시중심인민의원안과주원적익상노육환자80례80지안,안수궤수자표법분성량조,A조40례40지안행익상노육절제연합자체결막판이식술,B조40례40지안행익상노육절제연합양막이식술,분별우술전화술후l、3개월검사루막파렬시간(BUT)、Schirmer Ⅰ시험병작통계학분석.결과 A、B량조중술후1、3개월균교술전BUT축단、Schirmer Ⅰ감소,여술전비교차이유통계학의의(P＜0.05).A、B량조진행조간비교시,발현술후1、3개월시B조BUT교A조장,차이유통계학의의(P =0.014、0.027);술후1、3개월시B조Schirmer Ⅰ교A조다,차이무통계학의의(P＞0.05).결론 익상노육절제술후3개월내대루막공능유영향,술후3개월후루막분비공능축점회복.행익상노육절제연합양막이식술후조기대루막공능적영향소우익상노육절제연합자체결막판이식술.
Objective To explore the different surgical methods on tear function in patients with pterygium and its possible mechanism.Methods Eighty cases were treated from September 2010 to December 2012 in Yichang Central People's Hospital.Eighty cases of pterygium patients (80 eyes) were randomly divided into two groups,group A of 40 patients (40 eyes) underwent pterygium excision combined with conjunctival flap transplantation; group B of 40 patients (40 eyes) underwent pterygium excision combined with amnion transplantation.Respectively before and 1 month,3 months after surgery the tear film break-up time (BUT),Schirmer Ⅰ test were checked.Results BUT and Schirmer Ⅰ were shortened on both groups at 1 month and 3 months post-operation,and the differences were significant (P ＜0.05).BUT on group B was longer than the group A 1 month and 3 months postoperatively,the difference was significant (P 0.014,0.027),while for the two groups Schirmer Ⅰ 1 month and 3 months after surgery,there was no significant difference (P ＞0.05).Conclusions Pterygium excision affects tear film function at the early postoperative stage.Tear film function returns to preoperative levels 3 months after surgery.Influence of pterygium excision combined with amnion transplantation on function of the tear film is less than that of pterygium excision combined with conjunctival flap transplantation at early postoperative stage.