中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2015年
14期
61-63,66
,共4页
复发性翼状胬肉%准分子激光%激光治疗性角膜切削术%角膜缘干细胞移植
複髮性翼狀胬肉%準分子激光%激光治療性角膜切削術%角膜緣榦細胞移植
복발성익상노육%준분자격광%격광치료성각막절삭술%각막연간세포이식
Recurrent pterygium%Excimer laser%Phototherapeutic keratectomy%Corneal limbal stem cell autograft
目的：探讨准分子激光治疗性角膜切削术（PTK）在治疗复发性翼状胬肉中的手术要点和临床效果。方法回顾性分析我院2010年6月~2013年12月收治的51例（52眼）复发性翼状胬肉患者的临床资料，根据不同治疗方法随机分为两组，A组采用胬肉切除联合角膜缘干细胞移植术+PTK术，B组单纯采用胬肉切除联合角膜缘干细胞移植术，术后随访6个月。观察两组疗效并对术后角膜创面上皮愈合时间、角膜平整透明度、角膜散光、角膜新生血管生长情况及复发率等进行比较。结果角膜创面上皮平均愈合时间，A组为3~7（5.00±1.26）d，B组为4~8（6.25±1.36）d，差异有统计学意义（t=-2.65，P=0.013<0.05）。两组患者术后1、6个月的角膜散光比术前显著降低，术后同一时间A组与B组角膜散光度相比，差异有统计学意义（t=-2.26，P=0.03；t=-3.15，P=0.00）。病变区角膜平整及透明度方面A组优于B组（Z=-3.184，P=0.001约0.05）。 A组复发率为6.7%，B组复发率9.0%，两组间再次复发率差异无统计学意义（Fisher概率检验，P>0.05），但A组角膜新生血管增殖情况优于B组（Z=-3.053，P=0.002<0.05）。结论PTK治疗复发性翼状胬肉恢复较快，术后角膜平滑及透明度优于单纯采用胬肉切除联合角膜缘干细胞移植术，可供临床选用。
目的：探討準分子激光治療性角膜切削術（PTK）在治療複髮性翼狀胬肉中的手術要點和臨床效果。方法迴顧性分析我院2010年6月~2013年12月收治的51例（52眼）複髮性翼狀胬肉患者的臨床資料，根據不同治療方法隨機分為兩組，A組採用胬肉切除聯閤角膜緣榦細胞移植術+PTK術，B組單純採用胬肉切除聯閤角膜緣榦細胞移植術，術後隨訪6箇月。觀察兩組療效併對術後角膜創麵上皮愈閤時間、角膜平整透明度、角膜散光、角膜新生血管生長情況及複髮率等進行比較。結果角膜創麵上皮平均愈閤時間，A組為3~7（5.00±1.26）d，B組為4~8（6.25±1.36）d，差異有統計學意義（t=-2.65，P=0.013<0.05）。兩組患者術後1、6箇月的角膜散光比術前顯著降低，術後同一時間A組與B組角膜散光度相比，差異有統計學意義（t=-2.26，P=0.03；t=-3.15，P=0.00）。病變區角膜平整及透明度方麵A組優于B組（Z=-3.184，P=0.001約0.05）。 A組複髮率為6.7%，B組複髮率9.0%，兩組間再次複髮率差異無統計學意義（Fisher概率檢驗，P>0.05），但A組角膜新生血管增殖情況優于B組（Z=-3.053，P=0.002<0.05）。結論PTK治療複髮性翼狀胬肉恢複較快，術後角膜平滑及透明度優于單純採用胬肉切除聯閤角膜緣榦細胞移植術，可供臨床選用。
목적：탐토준분자격광치료성각막절삭술（PTK）재치료복발성익상노육중적수술요점화림상효과。방법회고성분석아원2010년6월~2013년12월수치적51례（52안）복발성익상노육환자적림상자료，근거불동치료방법수궤분위량조，A조채용노육절제연합각막연간세포이식술+PTK술，B조단순채용노육절제연합각막연간세포이식술，술후수방6개월。관찰량조료효병대술후각막창면상피유합시간、각막평정투명도、각막산광、각막신생혈관생장정황급복발솔등진행비교。결과각막창면상피평균유합시간，A조위3~7（5.00±1.26）d，B조위4~8（6.25±1.36）d，차이유통계학의의（t=-2.65，P=0.013<0.05）。량조환자술후1、6개월적각막산광비술전현저강저，술후동일시간A조여B조각막산광도상비，차이유통계학의의（t=-2.26，P=0.03；t=-3.15，P=0.00）。병변구각막평정급투명도방면A조우우B조（Z=-3.184，P=0.001약0.05）。 A조복발솔위6.7%，B조복발솔9.0%，량조간재차복발솔차이무통계학의의（Fisher개솔검험，P>0.05），단A조각막신생혈관증식정황우우B조（Z=-3.053，P=0.002<0.05）。결론PTK치료복발성익상노육회복교쾌，술후각막평활급투명도우우단순채용노육절제연합각막연간세포이식술，가공림상선용。
Objective To investigate the key points of operation and clinical effects of excimer laser phototherapeutic keratectomy(PTK) in the treatment of recurrent pterygium. Methods Perform a retrospective study method. 51 patients(52 eyes)who were diagnosed recurrent pterygium from June 2010 to December 2013 were allocated into two groups at randomgroup A was treated by pterygium excision and corneal limbal stem cell autograft (CAG) with PTK and group B was simply treated by CAG. They were followed up in the aspects of the reparation of cornea,astigmatism and the recovery of visual acuity for six months. The recurrence rate was also analyzed and compared. Results The average healing time of group A was 3-7 (5.00±1.26) d, while group B was 4-8 (6.25±1.36) d, the difference of which was statistically significant (t=-2.65, P=0.013<0.05). Two groups of patients' corneal astigmatism had been significantly reduced after one and six months. At the same time the difference of astigmatism degree between group A and group B was statistically significant (t=-2.26, P=0.03; t=-3.15, P=0.00). In areas of corneal smoothness and transparency,group A was better than group B (Z=-3.184, P=0.001<0.05). Recurrence rate in group A was 6.7%, while group B was 9.0%,there was no statistically significant difference in recurrence rates between the two groups(Fisher probability test, P>0.05), but the proliferation of corneal neovascularization in group A was reduced than that of group B(Z=-3.053,P=0.002<0.05). Conclusion The results suggest that PTK can be an effective therapeutic approach in the treatment of recurrent pterygium.
