摘要
目的比较低温等离子手术（LTP）和自体结膜移植（CAG）治疗原发性翼状胬肉的临床效果。方法前瞻性临床研究。对2013～2014年在解放军324医院眼科收治的原发性翼状胬肉患者63例，分为两组：低温等离子组（LTP组，30例）和自体结膜移植组（CAG组，33例）。LTP组采用翼状胬肉切除联合低温等离子处理创面，CAG组采用翼状胬肉切除联合自体结膜移植，其他相关治疗相同。术后观察：局部手术部位充血评分、术后疼痛评分、角膜上皮的愈合和原手术部位复发例数。结果全部患者手术部位均无缺损、坏死、感染，巩膜无坏死穿孔，CAG组移植物均生长良好。LTP组较CAG组术后在术后1d，3d，7d，1个月早期胬肉手术部位充血明显差异有统计学意义（P均〈0．01），在术后1d，3d，7d的疼痛分数更低差异有统计学意义（P均〈0．01）。LTP组较CAG组术后1d愈合率无统计学意义（r=2．283，P=-0．131），术后3d的角膜上皮完全愈合率更高差异有统计学意义（r=8．331，P=-0．004），术后5d所有患者角膜上皮完全愈合。LTP组与CAG组比较术后复发率无统计学变化，差异无统计学意义术后1个月（r=O．859，P=0．354）、3个月（r=O．458，P=0．498）、6个月（r=0．005，P=0．945），1年复发患者经局部药物治疗无变化。结论早期LTP组患者较CAG组疼痛轻，角膜上皮愈合时间快，CAG组较lJrrP组局部手术部位充血较轻，复发率无统计学意义，但是LTP组手术创伤更小，术后角膜更平整，是有效的治疗翼状胬肉的新技术，值得推广。
Objective To evaluate the differences of clinical effects between LTP and CAG treat- ment of primary pterygium. Methods Sixty-three patients were divided into 2 groups： LTP group （30 patients）and CAG group （33 patients）. LTP group was taken pterygium excision combined LTP, while CAG group was taken pterygium excision combined CAG. Other relative treatments were same. Local operation area congestion score, pain score, complete healing of cornea epithelium and recurrence were observed postoperatively. Results All patients bad no defects, necrosis, infection and sclera hole, and the autograft in LTP group grew well. Comparing with CAG group, LTP group had worse score of operation area after ld, 3d, 7d and lm （all P 〈0.01） of operation, and had better score of pain after ld, 3d and 7d （all P 〈0.01） of operation. LTP group compared with CAG group in complete healing rate of corneal epithelium： ld （X^2 =2.283, P =0.131） with no statistical differ- ence, 3d （X^2=8.331, P =0.004） with better complete healing rate, and 5d all cornea completely recov- ered. No statistical difference was found between LTP group and CAG group in recurrence rate： lm （X^2=0.859, P =0.354）, 3m （X^2=0.458, P =0.498）, 6m （X^2=0,005. P =0.945）, ly （no change）. Conclu-sions In the early stage, LTP group show less pain and more less recover time. No difference is found in recurrence rate, but the CAG group has less congestion. Less injury and more smooth cor- nea plane make LTP an effective new operation method for pterygium and it is worthy of promotion.
作者
陈康
蔡晓峰
秦驰
李旭清
庹瑶
赖佳
Chen Kang Cai Xiaofeng Qin Chi Li Xuqin Tuo Yao Lai Jia(Department of Ophthalmology, PLA 324 Hospital, Chongqin 400029, Chin)
出处
《中国实用眼科杂志》
2017年第1期32-36,共5页
Chinese Journal of Practical Ophthalmology
基金
重庆市科技攻关项目（cstc2013yykfal10002）
关键词
翼状胬肉
低温等离子
自体结膜移植
复发
Pterygium
Low-tempera^re plasma
Conjunctival autografting
Recurrence
