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目的:比较羊膜移植联合丝裂霉素C(mitomycin C,MMC)与羊膜移植在翼状胬肉治疗中的有效性和安全性。方法:我们进行Meta分析进行比较。计算机扩大检索Cochrane图书馆,MEDLINE,EMBASE,CBMdisc,CNKI.等数据库获得数据。通过Cochrane协作网提供的RevMan4.2软件进行数据统计分析。结果:羊膜移植联合MMC显著降低了翼状胬肉的复发率。但是否会增加术后的并发症仍需更多的临床试验证实。入选的6项临床试验均报道了翼状胬肉术后的复发率,包括882眼,3项临床试验报道了术后并发症情况。Meta分析的结果显示羊膜移植联合MMC组复发率为5.41%,只进行羊膜移植组复发率为16.89%,相对危险度为0.32,95%可信区间为0.19～0.56,Z值为4.06,P<0.001。2项研究报道了术后早期点状角膜炎的发生情况,羊膜移植联合MMC组与羊膜移植组的发病率分别为17.14%和0.00%,相对危险度为12.11,95%可信区间为1.62～90.76。结论:与羊膜移植相比,羊膜移植联合MMC联合治疗翼状胬肉显著降低了术后复发率。
Objective: To compare the efficacy and safety of amniotic membrane transplantation with mitomycin C (MMC) and amniotic membrane transplantation in the treatment of pterygium. Methods: We conducted a meta-analysis for comparison. Computers were expanded to retrieve data from databases such as the Cochrane Library, MEDLINE, EMBASE, CBMdisc, CNKI. RevMan4.2 software provided by the Cochrane Collaboration for data statistical analysis. Results: Amniotic membrane transplantation combined with MMC significantly reduced the recurrence rate of pterygium. But whether it will increase the postoperative complications still need more clinical trials confirmed. Six of the selected clinical trials reported the recurrence rate of pterygium surgery, including 882 eyes. Three clinical trials reported postoperative complications. The results of Meta analysis showed that the recurrence rate was 5.41% in amniotic membrane transplantation group and MMC group, 16.89% in amniotic membrane transplantation group, relative risk was 0.32, 95% confidence interval was 0.19 ~ 0.56, Z value was 4.06, P < 0.001.2 studies reported the incidence of early postoperative keratitis, the incidence of amniotic membrane transplantation combined with MMC and amniotic membrane transplantation group was 17.14% and 0.00%, the relative risk was 12.11, 95% confidence interval 1.62 ~ 90.76. Conclusion: Compared with amniotic membrane transplantation, amniotic membrane transplantation combined with MMC in the treatment of pterygium significantly reduced the recurrence rate.