不同手术方式治疗翼状胬肉对泪膜稳定性影响.docVIP

不同手术方式治疗翼状胬肉对泪膜稳定性的影响 　　【摘要】目的研究不同的手?g方式治疗翼状胬肉对泪膜稳定性的影响。方法选取2013年7月～2015年11月间接受治疗的96例翼状胬肉病人，根据手术方式分为Ⅰ、Ⅱ、Ⅲ三组，其中Ⅰ组为单纯切除，Ⅱ组行合并应用丝裂霉素C（MMC）切除术，Ⅲ组行联合角膜缘干细胞移植切除术，比较三组术前及术后基础泪液分泌值（SIt）、泪膜破裂时间（BUT）、眼表疾病指数（OSDI），并对术后复发率进行随访比较。结果术后三组基础泪液分泌值均较术前无明显变化（P0.05）；术后除Ⅰ组外，其余两组的BUT值均较术前明显延长，差异有统计学意义（P0.05）。三组术后3个月的OSDI值均升高，且与术前比较，差异有统计学意义（P0.05）；同时Ⅰ组和Ⅱ组的OSDI值均较Ⅲ组明显升高，差异有统计学意义（P0.05）。术后3个月三组的复发率比较差异有统计学意义，其中Ⅰ组复发率明显高于Ⅱ组（P0.05）。结论联合角膜缘干细胞移植治疗翼状胬肉是一种有效、安全且更理想的治疗手段，预后效果明显，可以有效改善术后泪膜泪液的功能，明显降低复发率，值得临床推广。 　　【关键词】翼状胬肉；手术治疗；泪膜稳定性；角膜缘干细胞移植 　　中图分类号：R777.33文献标识码：ADOI：DOI：10.3969/j.issn2018.02.019 　　Effects of different surgical methods for pterygium on the stability of tear film 　　PAN Liuqian，PENG Yinjun，TAN Shihua 　　（Ophthalmology Department，The First People’s Hospital of Hechi，Yizhou 546300，China） 　　【Abstract】ObjectiveTo study the effect of different surgical methods for pterygium on the stability of tear film.Methods96 cases of pterygium treated in our hospital from July，2013 to November，2015 were divided into groups Ⅰ，Ⅱ and Ⅲ according to surgical methods.The group Ⅰ were given simple operation excision，the group Ⅱ were combined with mitomycin C （MMC） resection，and the group Ⅲ were combined with limbal stem cell transplantation.Then，the value of Schirmer I test（SIt），tear film breakup time （BUT） and ocular surface disease index（OSDI） were compared between the three groups before and after operation，and postoperative recurrence rate was compared and followed up.ResultsThere was no significant change in the value of SIt in the three groups after operation（P0.05）.Except the group Ⅰ，the BUT of the other two groups after operation were significantly longer than those before operation，and difference was statistically significant（P0.05）.The OSDI of the three groups all obviously increased at three months after operation，and compared with those before operation，difference was statistically significant（P 　　【Key words】pterygium；surgical treatment；tear film stability；limbal stem cell tr