翼状胬肉逆行切除加自体角膜缘干细胞移植术的的疗效观察.docVIP

翼状胬肉逆行切除加自体角膜缘干细胞移植术的的疗效观察 　　[摘要]目的:观察翼状胬肉逆行切除加自体角膜缘干细胞移植防止术后胬肉复发的临床疗效。方法:对54例（58眼）翼状胬肉由体部逆行将头部自角膜上分离，采取术眼下方带角膜缘上皮的结膜移植于角膜、巩膜创面。结果:术后随访6～24个月，平均14个月，胬肉无复发，角膜恢复透明光滑，无新生血管长入。结论:翼状胬肉逆行切除加自体角膜缘干细胞移植能有效地降低胬肉术后复发率，美容效果好，是治疗翼状胬肉的一种简便、安全、有效的手术方法。 　　[关键词]翼状胬肉；逆行切除；角膜缘干细胞移植 　　[中图分类号]R777.33[文献标识码]A[文章编号]1008-6455（2007）09-1240-02 　　 　　Effect of retrograde excision of pterygium combined with selftransplantation of corneal limbus stem cells 　　ZHAO Ai-xia1,SI Xiao-hua2 　　(Department of Ophthalmology,the Second Affiliated Hospital of Henan College of Traditional Chinese Medicine,Zhengzhou 450002,Henan,China) 　　 　　Abstract： ObjectiveTo observe the clinical effect of the relapse of pterygium after retrograde excision and selftransplantation of corneal limbus stem cells to prevent the reoccurrence of pterygium.MethodsThe pterygium tissue was seperated from the cornea retrogradively, and then transplanted selftransplantation of corneal limbus stem cells to cover the naked sclera and cornea. This method was performed on 54 cases (58 eyes) with pterygium.ResultsThe post-operative follow-up periods ranged from 6 to 24 months (means, 14months).There was no reoccurrence ,no new blood vessels occurred and the corneal recovered to be transparent and smoothly.ConclusionThis method of retrograde excision of pterygium combined with selftransplantation of corneal limbus can reduce the reoccurrence of pterygium and improve the effect of cosmetology. Therefore , it is simple , safe and effective. 　　Keywords：pterygium; retrograde excision; selftransplantation of corneal limbus stem cells 　　 　　翼状胬肉是眼科的常见病和多发病，轻者影响美容，重者引起角膜散光或遮盖瞳孔而影响视力，手术切除是最主要的治疗方法，传统的手术方法术后复发率较高，我们近年来采用逆行切除加自体角膜缘干细胞移植术治疗54例（58眼）翼状胬肉患者，经长期随访观察，效果满意，现报道如下。 　　 　　1临床资料 　　 　　本组54例（58眼）翼状胬肉患者中，男24例（28眼），女30例（30眼），年龄31～71岁，平均52.3岁。单眼50例，双眼4例。初发胬肉41例（43眼），复发胬肉13例（15眼）。胬肉头部侵入角膜缘内3～7mm，均为鼻侧发病。 　　 　　2方法 　　 　　2.1 逆行切除胬肉：表麻后开睑，手术均在显微镜下进行，2%利多卡因0.2～0.4ml加少许0.1%肾上腺素（高血压患者禁用）注入胬肉体部结膜下浸润麻醉，并使之隆起，使胬肉的结膜面易于与下方增生组织分离，沿胬肉颈部上下两侧缘外约1