江会丰 欧阳君

[摘要]目的 探讨丝裂霉素C在翼状胬肉切除术后对泪膜稳定性的影响。方法 选取2016年1月～2017年5月九江市第一人民医院收治的86例原发性翼状胬肉患者（138眼），随机分为翼状胬肉切除伴羊膜移植组（A组），翼状胬肉切除伴羊膜移植联合应用丝裂霉素C（MMC）组（B组）。术前及术后1个月、3个月行泪液分泌试验（SIt）、泪膜破裂时间（BUT）、角膜荧光素染色（CFS）检查。结果 术后1个月，两组的CFS、BUT与术前比较，差异有统计学意义（P<0.05），两组间比较，差异有统计学意义（P<0.05）；术后1个月，两组的SIt较术前及组间比较差异均无统计学意义（P>0.05）；术后3个月，两组的CFS、BUT、SIt较术前及组间比较差异均无统计学意义（P>0.05）。结论 胬肉切除术后早期对泪膜功能有影响，术后3个月泪膜功能基本恢复正常；翼状胬肉切除伴羊膜移植术后早期对泪膜功能影响小于翼状胬肉切除伴羊膜移植联合应用MMC。

[关键词]翼状胬肉；羊膜移植；翼状胬肉切除；丝裂霉素C；泪膜

[中图分类号] R777.33 [文献标识码] A [文章编号] 1674-4721（2018）4（b）-0105-03

Influence of Mitomycin C on the stability of tear film after pterygium surgery

JIANG Hui-feng OUYANG Jun

Department of Ophthalmology，No.1 People′s Hospital of Jiujiang City in Jiangxi Province，Jiujiang 332000，China

[Abstract]Objective To investigate the influence of Mitomycin C the stability of tear film after pterygium surgery.Methods A total of 86 （138 eyes） patients with primary pterygium admitted into our hospital from January 2016 to May 2017 were selected，and randomly divided into pterygium excision with amniotic membrane transplantation （group A） and pterygium excision combined with amniotic membrane transplantation and mitomycin C （MMC） group （group B）.The tear secretion test （Schirmer I），break-up time （BUT） of the tear film and corneal fluorescein staining （CFS） examination were performed before surgery，1 and 3 months after surgery.Results One month after operation，the CFS and BUT of the two groups were significantly different from those before operation （P<0.05）.There were significant differences in the two indicators after inter-group comparison （P<0.05）.One month after surgery，there was no significant difference in SIt before surgery or after inter-group comparison （P>0.05）.Three months after operation，no great difference was displayed in CFS，BUT，or SIt compared with prior surgery or between the two groups （P>0.05）.Conclusion pterygium resection in early stage has some influence on the function of tear film.Three months after surgery，the function of tear film becomes basically normal.Compared with pterygium excision combined with amniotic membrane transplantation and MMC，the impact on the function of tear film by pterygium excision and amniotic membrane transplantation at early stage is milder.

[Key words]Pterygium；Amniotic membrane transplantation；Pterygium excision；Mitomycin C；Tear film

翼狀胬肉为眼科常见的眼表疾病，在我国翼状胬肉有较高的患病率，农村地区最高，可达13.88%[1]，一般认为其是受外界剌激而引起的一种慢性炎症性病变，双眼或单眼受犯，因其形似昆虫的翅膀故得名。睑裂部球结膜及结膜下组织发生肥厚、增生、变性，呈三角形，向角膜内发展，侵犯角膜后日渐增大，时间长甚至可覆盖至瞳孔区而影响视力[2]。本病多见于户外劳动者，以渔民、农民发 病最多，流行病学调查[3]显示环境因素，如烟雾、风尘、紫外线等是翼状胬肉的重要诱发因素。翼状胬肉会引起患者眼部干涩不适、视力下降、散光及长期眼红等问题。目……