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目的:比较原发性和复发性翼状胬肉羊膜移植术和自体结膜瓣移植术的效果,测定指标为术后复发率。方法:对从2004-04/2006-02连续翼状胬肉病例作前瞻性研究。患者被随机分为2组:羊膜移植组(26例)和自体结膜瓣移植组(24例)。所有病例均用羊膜移植术或自体结膜瓣移植术,并广泛切除纤维血管组织。随访24mo观察复发和并发症。手术操作由同一位手术医师施行。对人口统计变数、手术技术、复发和术后并发症的相关性进行分析。结果:患者男女比例为4∶1,右眼与左眼的比例为3∶2。其中70%翼状胬肉是原发性,30%为复发。最常见的临床症状是眼部充血和视力下降,最常见的并发症是复发和角膜瘢痕。随访1mo,羊膜移植组和自体结膜瓣移植组的复发率分别为3.8%,8.3%,随访24mo后比例上升为46.2%,25%。结论:自体结膜瓣移植术后2a随访的成功率更好。翼状胬肉羊膜移植术复发率高,不被广泛接受。
OBJECTIVE: To compare the efficacy of amniotic membrane transplantation and autologous conjunctival flap transplantation in patients with primary and recurrent pterygium. The measured index is the postoperative recurrence rate. Methods: A prospective study of consecutive cases of pterygium from 2004-04 / 2006-02 was conducted. Patients were randomly divided into 2 groups: amniotic membrane transplantation group (26 cases) and autologous conjunctival flap transplantation group (24 cases). All cases were treated with amniotic membrane transplantation or autologous conjunctival flap transplantation, and extensive excision of vascular tissue. Follow-up 24mo observed recurrence and complications. Surgery performed by the same surgeon. Analysis of demographic variables, surgical techniques, relapse, and postoperative complications. Results: The ratio of male to female was 4: 1, and the ratio of right eye to left eye was 3: 2. Of which 70% of pterygium is primary, 30% of the recurrence. The most common clinical signs of ocular congestion and decreased vision, the most common complication is recurrence and corneal scarring. Follow-up 1mo, the recurrence rate of amniotic membrane transplantation group and autologous conjunctival flap transplantation group were 3.8%, 8.3%, respectively, followed up for 24 months, the proportion rose to 46.2%, 25%. CONCLUSIONS: Follow-up at 2a after autologous conjunctival flap transplantation has a better success rate. Pterygium amniotic membrane transplantation has a high recurrence rate and is not widely accepted.