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目的比较不同翼状胬肉手术的疗效及术前术后泪膜稳定性的改变。方法 84例(84眼)随机分为A、B、C三组,A组为单纯翼状胬肉切除,B组为翼状胬肉切除联合角膜缘干细胞移植,C组为翼状胬肉切除,术中应用0.2%丝裂霉素C,比较各组间术前及术后1月基础泪液分泌试验(Shirm-er I test)和泪膜破裂时间(break-up time,BUT)的变化,比较各组术后复发率。结果 A、B、C三组术前与术后的基础泪液分泌值分别相比,其变化均无显著意义(P>0.05),A组术前与术后BUT的变化无显著差异(P>0.05),B、C组分别将术前与术后1月比较,BUT显著延长,其变化有显著差异(P<0.05),而B、C两组相比,BUT的变化无显著差异(P>0.05),术后观察24~36月,A组复发5例,B组复发2例,C组复发3例,三组间的复发率相比,无明显差异(P>0.05)。结论翼状胬肉切除联合角膜缘干细胞移植能有效预防术后复发,对泪膜稳定性影响小,术中应该丝裂霉素C能抑制成纤维母细胞的增殖,从而减少术后复发,其操作简便,对泪膜稳定性影响也小,患者术后不适症状减轻,这两种方法安全有效,值得推广应用。
Objective To compare the curative effect of different pterygium surgery and the change of tear film stability after operation. Methods 84 cases (84 eyes) were randomly divided into three groups: A, B and C, group A was simple pterygium excision, group B was pterygium excision combined with limbal stem cell transplantation, group C was pterygium excision, 0.2% mitomycin C was applied to compare the changes of basal tear secretion test (Shirm-er I test) and tear-break time (BUT) before and after January, Postoperative recurrence rate. Results There was no significant difference in basal lacrimal fluid secretion between groups A, B and C (P> 0.05), but there was no significant difference between group A and B after operation (P> 0.05). There was significant difference in BUT between B and C groups (P <0.05), while there was no significant difference between B and C groups (P> 0.05) > 0.05). There was no difference between the three groups (P> 0.05). There were no significant differences between the three groups (P> 0.05). Conclusions Pterygium excision combined with limbal stem cell transplantation can effectively prevent postoperative recurrence and has little effect on tear film stability. Mitomycin C should be used to inhibit the proliferation of fibroblasts and reduce the recurrence after operation. Simple, the impact on the stability of the tear film is also small, alleviate the symptoms of postoperative patients, both safe and effective, it is worth promoting the application.