| 李 娜,黄学文,周米露,万 宇,黄 海.老年翼状胬肉患者翼状胬肉切除与角膜缘干细胞移植联合治疗的疗效观察[J].,2022,(23):4596-4600 |
| 老年翼状胬肉患者翼状胬肉切除与角膜缘干细胞移植联合治疗的疗效观察 |
| Efficacy of Pterygium Excision Combined with Limbal Stem Cell Transplantation in the Treatment of Elderly Patients with Pterygium |
| 投稿时间：2022-04-28 修订日期：2022-05-23 |
| DOI：10.13241/j.cnki.pmb.2022.23.039 |
| 中文关键词: 翼状胬肉 翼状胬肉切除术 角膜缘干细胞移植术 泪膜功能 |
| 英文关键词: Pterygium Pterygium excision Limbal stem cell transplantation Tear film function |
| 基金项目:四川省卫生健康委科研项目（普及应用项目）（2020PJ300） |
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| 中文摘要: |
| 摘要 目的：分析评估老年翼状胬肉患者实施翼状胬肉切除与角膜缘干细胞移植联合治疗的临床效果。方法：回顾性纳入的本院2018年08月至2020年07月期间295例翼状胬肉患者（共442只眼）的临床资料，根据术式差异将患者分为联合组（150例，共224只眼）和参照组（145例，共218只眼），参照组病患仅择取翼状胬肉切除手术，联合组病患于以上基础实施角膜缘干细胞移植术，比较两组病患术前及术后各时间点（1周、1个月、3个月）的BUT、SIt、UCVA、CAD、CAA，统计病患术后3个月的复发情况。结果：两组BUT在术后1周较术前显著缩短（P<0.05），而在术后1月和3月较术前显著延长（P<0.05），两组BUT在术后1周对比差别明显（P<0.05），而其他时间点对比没有明显差别（P>0.05）。两组术前术后SIt对比没有明显差别（P>0.05），术后1月和3月的两组UCVA均高于术前（P<0.05），而两组在各时间点UCVA对比没有明显差别（P>0.05），两组术后各时间点的角膜CAD较术前显著性降低（P<0.05），而两组角膜CAD在各时间点无明显差别（P>0.05）。两组术后CAA术后3月与术前比较，WR比例显著降低，AR、OA比例显著增加（P<0.05），而组间对比没有明显差别（P>0.05）。术后复发率联合组（6.67%）与参照组（32.26%）对比有明显差别（P<0.05）。结论：与翼状胬肉切除术比较 ，老年翼状胬肉病患实施翼状胬肉切除与角膜缘干细胞移植术联合治疗对患者早期眼表无较大影响，两种术式均不影响泪液分泌，且能够改善裸眼视力、散光度及轴向，但联合治疗在降低术后复发率方面优势明显。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the clinical effect of pterygium excision combined with limbal stem cell transplantation in the treatment of elderly patients with pterygium. Methods: The clinical data of 295 patients with pterygium (442 eyes in total) from August 2018 to July 2020 in our hospital were retrospectively included. The patients were divided into combined group (150 cases, 224 eyes) and reference group (145 cases, 218 eyes) according to different operation methods. Patients in the reference group were treated with pterygium excision, and those in the combined group were treated with limbal stem cell transplantation on this basis. The two groups were compared in terms of BUT, SIt, UCVA, CAD and CAA before operation and at different time points (1 week, 1 month and 3 months) after operation. Recurrence within 3 months after operation was analyzed. Results: BUT of the two groups was significantly shortened at 1 week after operation (P<0.05), and was significantly prolonged at 1 month and 3 months after operation (P<0.05). There was a significant difference in BUT between the two groups at 1 week after operation (P<0.05), but there was no significant difference at the other time points (P>0.05). There was no significant difference in SIt in the two groups before and after treatment (P>0.05). UCVA of the two groups was significantly increased at 1 month and 3 months after operation (P<0.05), but there was no significant difference between the two groups at each time point (P>0.05). CAD of the two groups was significantly decreased at each time point after operation (P<0.05), but there was no significant difference between the two groups at each time point (P>0.05). Comparison of CAA in the two groups before operation and at 3 months after operation showed that the proportion of WR was significantly decreased, while the proportions of AR and OA were significantly increased (P<0.05). There was no significant difference in CAA distribution between two groups (P>0.05). The postoperative recurrence rate in the combined group (6.67%) was significantly lower than that in the reference group (32.26%) (P<0.05). Conclusion: Compared with pterygium excision, pterygium excision combined with limbal stem cell transplantation has no significant influence on early ocular surface. The two operation methods have no influence on tear secretion, and both can improve UCVA, astigmatism and CAA. The combined treatment has more advantages in reducing postoperative recurrence rate. |
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