蒋顺 张新月 凌家文

[摘要]目的：观察角膜绷带镜辅助翼状胬肉切除术与翼状胬肉切除术联合自体角膜缘干细胞结膜移植治疗翼状胬肉的疗效，探讨翼状胬肉切除术联合自体角膜缘干细胞结膜移植的有效性及安全性。方法：按照随机数字法将2015年5月-2017年5月笔者医院收治的100例（100眼）原发性翼状胬肉患者分为对照组与观察组，每组50例（50眼）。对照组采用角膜绷带镜辅助翼状胬肉切除术进行治疗，观察组采用翼状胬肉切除术联合自体角膜缘干细胞结膜移植进行治疗，术后随访1年。比较两组患者手术后眼表情况、复发率、角膜上皮修复时间及并发症发生情况。结果：观察组的角膜上皮修复时间[（3.06±0.94）d]明显短于对照组的（5.78±1.15）d，差异有统计学意义（t=2.735，P=0.006）。观察组复发率为4.00%（2/50） 明显低于对照组的28.00%（14/50），差异有统计学意义（χ2=10.348，P=0.017）。观察组并发症发生率为2.00%（1/50） 低于对照组的10.00%（5/50），差异有统计学意义（χ2=8.226，P=0.035）。结论：自体角膜缘干细胞结膜移植治疗翼状胬肉能够明显缩短原发性翼状胬肉患者的角膜上皮修复时间，同时降低复发率及并发症发生率。

[关键词]原发性翼状胬肉;复发率;自体角膜缘干细胞结膜移植;角膜绷带镜

[中图分类号]R622    [文献标志码]A    [文章編号]1008-6455（2019）02-0103-03

Abstract： Objective  To observe the curative effect of corneal bandage mirror assisted pterygium excision and pterygium excision combined with autologous limbal stem cell conjunctival transplantation， and to explore the efficacy and safety of pterygium excision combined with autologous limbal stem cell conjunctival transplantation.  Methods  Retrospective analysis of 100 patients who were underwent primary pterygium surgery was performed from May 2015 to May 2017.50 cases were treated with corneal bandage mirror assisted pterygium excision，which were named control group，50 cases were treated with pterygium excision combined with autologous limbal stem cell conjunctival transplantation， which were named observation group .The follow-up period was 1 year. Ocular surface condition， recurrence rate， corneal epithelial repair time and complications were compared between the two groups after surgery. Results  The repair time of corneal epithelium in the observation group [（3.06±0.94）d] was significantly shorter than that in the control group [（5.78±1.15）d]， and the difference was statistically significant （t=2.735， P=0.006）. The recurrence rate of the observation group was 4.00% （2/50）， which was significantly lower than that of the control group （28.00% ，14/50）， and the difference was statistically significant （χ2=10.348， P=0.017）. The incidence of complications in the observation group was 2.00% （1/50） lower than that in the control group （10.00%， 5/50）， the difference was statistically significant （χ2= 8.226， P=0.035）. Conclusion  Autologous limbal stem cell conjunctival transplantation can significantly shorten the corneal epithelial repair time of patients with primary pterygium， and reduce the recurrence rate and complications

Key words： primary pterygium; recurrence; corneal limbal stem cell conjunctival transplantation; corneal bandage lens

原发性翼状胬肉是由于结膜受到慢性刺激而引起的一种慢性炎症性病变，可以对角膜鼻侧、颞侧、双侧进行侵入，鼻侧的侵入较常见[1-2]。目前，手术是治疗原发性翼状胬肉唯一有效的方法，虽然临床上的手术方法繁多，但是术后复发是一个值得重视的问题[3]。……