高宗宝 严静 廖杨

[摘要] 目的 探討翼状胬肉患者行胬肉切除术同时给予自体角膜缘干细胞移植与丝裂霉素C联合治疗的效果，为临床选取治疗方案提供参考。 方法 选取2017年1月—2019年2月于安徽省六安市中医院眼科就诊的翼状胬肉患者104例（135眼）为研究对象，根据简单数字随机分组法将其分成观察组52例（66眼）与对照组52例（69眼）。对照组采用翼状胬肉切除自体角膜缘干细胞移植治疗，观察组采用翼状胬肉切除自体角膜缘干细胞移植联合丝裂霉素C治疗，随访12个月。比较两组临床疗效、康复情况、角膜散光度、并发症及复发情况。 结果 观察组总有效率明显高于对照组，差异有统计学意义（P < 0.05）。术后两组角膜上皮修复时间、眼部刺激症消失时间及移植片愈合时间比较，差异无统计学意义（P > 0.05）。两组术后3个月角膜散光度均较术前明显下降，且观察组显著低于对照组，差异均有统计学意义（均P < 0.05）。两组术后3个月内并发症率比较，差异无统计学意义（P > 0.05）。观察组总复发率明显低于对照组，差异有统计学意义（P < 0.05）。 结论 翼状胬肉患者行胬肉切除术同时给予自体角膜缘干细胞移植与丝裂霉素C联合治疗的治愈率高，角膜散光度改善效果好，术后复发率低，推广应用价值高。

[关键词] 翼状胬肉;翼状胬肉切除术;自体角膜缘干细胞移植;丝裂霉素C;疗效;复发率

[中图分类号] R779.6          [文献标识码] A          [文章编号] 1673-7210（2020）07（c）-0129-04

Effect of pterygium excision autologous limbal stem cell transplantation combined with mitomycin C in the treatment of pterygium

GAO Zongbao   YAN Jing   LIAO Yang

Department of Ophthalmology， Traditional Chinese Medicine Hospital of Lu′an， Anhui Province， Lu′an   237006， China

[Abstract] Objective To investigate the effect of pterygium excision combined with autologous limbal stem cell transplantation and mitomycin C in the treatment of patients with pterygium， and to provide a reference for clinical treatment selection. Methods A total of 104 pterygium patients （135 eyes） admitted to the Department of Ophthalmology， Traditional Chinese Medicine Hospital of Lu′an from January 2017 to February 2019 were selected as study subjects. According to the simple number random grouping method， they were divided into the observation group with 52 cases （66 eyes） and the control group with 52 cases （69 eyes）. The control group was treated with pterygium excision autologous limbal stem cell transplantation， while the observation group was treated with pterygium excision autologous limbal stem cell transplantation combined with mitomycin C， follow-up for 12 months. Clinical efficacy， rehabilitation， corneal astigmatism， complications and recurrence were compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group， with statistically significant difference （P < 0.05）. There was no significant difference in the repair time of corneal epithelium， the disappearance time of ocular irritation and the healing time of grafts between the two groups after surgery（P > 0.05）. Three months after surgery， the corneal astigmatism of both groups was significantly decreased compared with that before surgery， and the observation group was significantly lower than the control group， with statistically significant differences （all P < 0.05）. There was no significant difference between the two groups in the complication rate within 3 months after surgery （P > 0.05）. The total recurrence rate in the observation group was significantly lower than that in the control group， with statistically significant difference （P < 0.05）. Conclusion The curative rate of pterygium excision combined with autologous limbal stem cell transplantation and mitomycin C in patients with pterygium is high， the improvement of corneal astigmatism is good， the postoperative recurrence rate is low， and the application value is high.

[Key words] Pterygium; Pterygium excision; Autologous limbal stem cell transplantation; Mitomycin C; Efficacy; Recurrence rate

翼状胬肉是临床眼科常见眼表疾病之一[1]。目前，尚无对翼状胬肉治疗的特效药，放射治疗、激光治疗等对翼状胬肉的效果也不明显，因此手术切除是临床应用最多的治疗手段[2]。但临床发现，单纯翼状胬肉切除术后的炎症反应会导致新生血管生长及纤维细胞增生，复发率较高。据统计，单纯翼状胬肉切除术治疗的复发率为25%～45%[3]。翼狀胬肉术后复发已成为困扰眼科医师的一大难题。近年来，自体角膜肝细胞移植术开始用于翼状胬肉治疗。……