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角膜缘干细胞移植与羊膜移植治疗翼状胬肉临床效果对比分析(1)
http://www.100md.com 2017年10月8日 《中外医疗》 2017年第17期
     [摘要] 目的 观察角膜缘干细胞移植与羊膜移植治疗翼状胬肉的临床效果,分析研究其差异。方法 方便收集该院2012年1月—2016年1月收治的翼状胬肉患者2 000例,随机分两组,所有患者给予翼状胬肉切除,后给予移植术。羊膜移植组采用的术式为羊膜移植治疗;干细胞移植组采用的术式为角膜缘干细胞移植,其余手术方式相同。就两组患者创面平均愈合时间和翼状胬肉治愈率、翼状胬肉1年复发率进行比较。 结果 干细胞移植组患者创面平均愈合时间(4.11±0.15)d均明显优于羊膜移植组(6.24±1.91)d(P<0.05)。干细胞移植组翼状胬肉治愈率97.80%明显高于羊膜移植组83.50%,(P<0.05)。干细胞移植组翼状胬肉1年复发率0.50%明显低于羊膜移植组4.80%(P<0.05)。结论 角膜缘干细胞移植与羊膜移植治疗翼状胬肉临床效果对比,前者效果更好,可加速角膜创面愈合,降低复发率,二者存在明显差异,因此,可将角膜缘干细胞移植可作为翼状胬肉首选手术方式,在临床推广和应用。

    [关键词] 角膜缘干细胞移植;羊膜移植;翼状胬肉;临床效果

    [中图分类号] R777.33 [文献标识码] A [文章编号] 1674-0742(2017)06(b)-0101-03

    [Abstract] Objective To observe the clinical effect of limbal stem cell transplantation and amniotic membrane transplantation in treatment of pterygium and analyze and research the difference. Methods 2000 cases of patients with pterygium in our hospital from January 2012 to January 2016 were convenient selected and randomly divided into two groups, the pterygium of all patients were removed and were given the transportation, and the operation method in the amniotic membrane transplantation group was amniotic membrane transplantation treatment, and the main operation method in the stem cell transplantation group was stem cell transplantation, and the other operation methods were the same, and the average healing time of wound, cure rate of pterygium and recurrence rate in 1 year of pterygium were compared between the two groups. Results The average wound healing time in the stem cell transplantation group was obviously better than that in the amniotic membrane transplantation group[(4.11±0.15)d vs (6.24±1.91)d](P<0.05), and the cure rate of pterygium in the stem cell transplantation group was obviously higher than that in the amniotic membrane transplantation group(97.80% vs 83.50%)(P<0.05), and the recurrence rate in 1 year of pterygium in the stem cell transplantation group was obviously lower than that in the amniotic membrane transplantation group(0.50% vs 4.80%)(P<0.05). Conclusion The clinical effect of stem cell transplantation is better than that of amniotic membrane transplantation, which can accelerate the cornea wound healing, reduce the recurrence rate, and there are obvious differences, therefore, the limbal stem cell transplantation can be used as the primary operation method of pterygium, and it is worth clinical promotion and application.

    [Key words] Limbal stem cell transplantation; Amniotic membrane transplantation; Pterygium; Clinical effect

    翼狀胬肉是常见多发眼表疾病,为睑裂部球结膜和纤维血管组织向角膜三角形侵入形态像翼状的病症,在户外工作者中多发。目前关于翼状胬肉尚未明晰其发病原因,多认为和风尘接触、气候以及紫外线照射等相关,以慢性刺激后作用于结膜下组织胶原纤维为病理机制,可导致角膜前弹力层损伤而纤维组织变形,结缔组织增生,并长入变形角膜形成翼状胬肉。翼状胬肉发生后可出现结膜充血,患者可伴随不适,影响外观,甚至可影响视力。目前临床对翼状胬肉多采用单纯切除暴露方法,但复发率高,恢复慢[1]。该研究方便收集该院2012年1月—2016年1月收治的翼状胬肉患者2 000例分两组,探讨了角膜缘干细胞移植与羊膜移植治疗翼状胬肉临床效果,现报道如下。, 百拇医药(周成银 陈正勇)
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