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目的:探讨翼状胬肉切除术后角巩膜缘重建患者眼表病理学指标恢复情况,为临床诊治、评价提供病理学依据。方法:选取62例翼状胬肉切除术后角巩膜缘重建患者,于治疗前后对健侧、患侧眼均行印迹细胞学检查,治疗后行健、患侧泪膜破裂时间检查。并作健、患侧眼病理学指标比较和治疗前后患眼鳞状上皮化生情况比较。结果:62例患者角巩膜缘重建后眼表上球结膜、睑间结膜、下球结膜、下睑结膜处的杯状细胞计数健患侧眼比较,数据[(5.0±3.4)、(1.7±0.6)、(-1.2±0.4)、(4.9±1.3)]差异无统计学意义(P>0.05)。每例患者患眼与健眼泪膜破裂时间(BUT)比较,患眼均值为(12.3±2.1)s,健眼为(12.6±2.2)s,平均差值(0.3±0.1)s,差异无统计学意义(P>0.05)。所有患眼未见双核、固缩细胞,总炎症细胞出现率约为8%。治疗前后患者眼表鳞状上皮化生分级治疗后秩和大于治疗前,总体分级降低(Hd=18.3),差异有统计学意义(P<0.05)。结论:翼状胬肉术后角巩膜缘重建患者能够良好恢复泪液分泌的数量和质量,鳞状上皮化生可停止甚至恢复正常的细胞增殖凋亡。
Objective: To investigate the recovery of ocular surface pathology in patients with limbal reconstruction after limbus pterygium excision, and provide the pathological basis for clinical diagnosis and evaluation. Methods: Sixty - two patients with limbal reconstruction after limbal resection were enrolled in this study. Before and after treatment, bilateral cytology was performed on both contralateral and contralateral eyes. And for health, ipsilateral ophthalmology and pathology compared with before and after treatment eyes squamous metaplasia situation comparison. Results: The number of goblet cells on conjunctiva, palpebral conjunctiva, inferior bulbar conjunctiva and inferior conjunctival surface in 62 patients with corneal limbal reconstruction was significantly higher than that in healthy eyes ([5.0 ± 3.4], (1.7 ± 0.6), (-1.2 ± 0.4), (4.9 ± 1.3)]. There was no significant difference between the two groups (P> 0.05). There was no statistically significant difference between the eyes of each patient and healthy tear burst time (BUT), the average eye score was (12.3 ± 2.1) s and the healthy eye was (12.6 ± 2.2) s, the average difference was (0.3 ± 0.1) s Significance (P> 0.05). No binucleated, pyknotic cells were observed in all affected eyes, and the incidence of total inflammatory cells was about 8%. Before and after treatment, the rank sum of squamous metaplasia in patients with ocular epithelial metaplasia was significantly lower than that before treatment (Hd = 18.3), the difference was statistically significant (P <0.05). CONCLUSIONS: Patients with limbal reconstruction of limbal limbus can well restore the quantity and quality of tear secretion. Squamous metaplasia can stop or even resume normal cell proliferation and apoptosis.