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翼状胬肉不同手术方式对泪液功能的影响研究目的：研究通过对比翼状胬肉患者术前和术后泪液功能的改善，来探究不同手术方式对翼状胬肉患者治疗的临床效果。
方法：选择我院收治的患有翼状胬肉的患者50例（50只眼），随机分为翼状胬肉切除联合带蒂结膜瓣移植术组（对照组）和翼状胬肉切除联合自体角膜缘干细胞移植术组（观察组），对比两组患者的BUT，CSF、Schirmer I以及术后复发情况。
结果：两组患者BUT和CSF 比较（t=9.152、10.952，P=0.014、0.005），复发率比较（x2=12.479，P=0.000），均具有统计学意义（P＜0.05）。
结论：翼状胬肉切除联合自体角膜缘干细胞移植术是治疗翼状胬肉患者较为理想的手术方式，能够有效地降低术后的复发率。
标签：翼状胬肉；手术；泪液功能近年来，翼状胬肉切除术后，患者会出现泪膜稳定性下降，严重时甚至出现干眼症。
相关数据表示：对于翼状胬肉患者采用手术治疗，其术后复发率高达21%～58%。
本研究对我院翼状胬肉患者采用翼状胬肉切除联合自体角膜缘干细胞移植术，比较治疗效果如下。
1资料与方法1.1一般资料选择2013年1月1日至2015年12月1日我院收治的患有翼状胬肉的患者50例（50只眼），其中男28例，女22例，年龄36～59岁，平均（47.51±11.07）岁，入组患者均为初发，且胬肉侵犯角膜范围约2～5mm。
采用随机数字表法，将患者随机分为观察组和对照组，观察组25例，平均（47.42±11.36）岁，对照组25例，平均（47.74±11.04）岁，两组患者在年龄、性别、临床资料等方面比较差异不显著，可进行本研究。
1.2方法入组患者术前均使用诺氟沙星滴眼液3天，在翼状胬肉体部结膜下使用2%利多卡因注射液1mL，在显微镜下翼状胬肉平行于角膜边缘2～3mm切开球结膜，充分使结膜与翼状胬肉的纤维组织分离，剪断翼状胬肉，夹住颈部，反向剥离至角膜边缘，剪断两边的筋膜，从头部向颈部钝性分离，完整地撕除翼状胬肉组织。
两种术式治疗原发性翼状胬肉致干眼症的临床随访观察【摘要】目的随访观察两种术式治疗原发性翼状胬肉致干眼症的阳性率。
方法原发性翼状胬肉患者80例80眼，随机分成两组，a组：40例（40眼）；b组：40例（40眼）。
a组：行丝裂霉素联合翼状胬肉切除术。
b组：行翼状胬肉切除术联合角膜缘干细胞移植术。
分别于术前和术后6个月检查泪膜破裂时间（but）、schirmer i试验、角膜荧光素染色，来评价翼状胬肉及胬肉切除术后6个月引起干眼症的情况。
结果术后随访6个月。
a组：12例（12眼）出现眼部干涩，阳性率为30.0%。
b组：3例（3眼）出现眼部干涩，阳性率为7.5%。
结论翼状胬肉切除联合自体角膜缘干细胞移植术较丝裂霉素联合翼状胬肉切除术后远期观察随访，临床疗效好，患者乐于接受，术后引起干眼症的几率小，利于临床推广。
【关键词】两种术式；原发性翼状胬肉；干眼症翼状胬肉是一种眼科门诊的常见疾病，目前主要的治疗方法是以手术为主。
在临床工作中部分患者术后引起眼部干涩、疼痛、异物感等症状，重者可引起干眼症。
本研究通过观察丝裂霉素联合翼状胬肉切除术和翼状胬肉切除术联合角膜缘干细胞移植术来比较原发性翼状胬肉患者不同的手术方式术后引起干眼症发生的阳性率。
1 资料与方法1.1 一般资料选择承德市中医院眼科2008年12月至2010年3月门诊及住院的80例（80眼）原发性翼状胬肉患者，随机分为2组。
a组：40例（40眼），平均年龄57.42±3.46岁，男性23例，女性17例，行丝裂霉素c联合翼状胬肉切除术。
b组：40例（40眼），平均年龄56.38±6.41岁，男性15例，女性25例，行翼状胬肉切除联合角膜缘干细胞移植术；患者翼状胬肉全部是原发性的，除外其他眼部疾病史及治疗史。
a、 b两组的年龄大小、性别差异无统计学意义，具有可比性。
1.2 手术方法手术均由同一术者在显微镜下操作完成。
手术步骤：a组：局部麻醉，沿翼状胬肉颈部剪开结膜并向鼻侧分离至泪阜，在翼状胬肉头部沿前弹力层剥离并将胬肉头、颈、体全部切除，剪除变性的结膜组织。
不同手术方式对原发性翼状胬肉患者角膜屈光及术后巩膜溶解并发症的影响张碧华;杨晓英【摘要】Objective To explore the effect of different surgery approaches on corneal refraction and scleral dissolution of primary pterygium patients.Methods A total of 195 primary pterygium patients selected in Sichuan Panzhihua Institute Affiliated Hospital from Jan.2013 to Dec.2014 were divided into study group 1 of 65 cases(74 eyes) ,study group 2 of 65 cases(71 eyes) and study group 3 of 65 cases(73 eyes) accord-ing to random number table method.Study group 1 underwent pterygium excision,study group 2 received pte-rygium excision combined with limbal stem cell transplantation , study group 3 received pterygium excision combined with amniotic membrane transplantation.The naked visual acuity,corneal curvature and corneal astigmatism of the three groups before and 1 month,3 months after operation were compared,and ocular irrita-tion symptoms after 1 week,2 weeks,and scleral complications after 6 months of treatment were recorded. Results After surgery,the uncorrected visual acuity[(0.41 ±0.09),(0.56 ±0.14),(0.47 ±0.10), (0.64 ±0.16),(0.48±0.11),(0.63 ±0.17)],corneal horizontal curvature[(42 ±7),(44 ±8),(45 ± 9),(46 ±8),(45 ±8),(46 ±9) D],vertical corneal curvature[(42.1 ±7.5),(43.4±8.7),(44.5 ± 8.6),(46.4 ±10.1),(44.9 ±8.9),(46.7 ±9.5) D] of the three groups showed a rising trend,corneal astigmatism degree[(1.21 ±0.32),(0.91±0.11),(0.82 ±0.21),(0.63 ±0.2),(0.81 ±0.3), (0.50 ±0.20) D] was decreased,ascompared with before treatment[(0.33 ±0.06),(0.32 ±0.07), (0.33±0.09),(40 ±6),(40 ±5),(39 ±6),(40.3 ±6.9),(40.3 ±7.1),(41.1 ±7.4),(1.6 ± 0.4),(1.5±0.4),(1.6 ±0.5) D] with statistically significant difference(P <0.05).Study group 2, study group 3′s naked visual acuity,corneal horizontalcurvatur,vertical corneal curvature were significantly higher than study group 1 at one month and 3 months after surgery(P<0.05).Study group2,study group 3′s eye irritation symptoms incidence were significantly lower than study group 1 at one week and two weeks after surgery[1 week after surgery:42.3%(30/71),46.6% (34/73) vs 70.3%(52/74);two weeks after sur-gery:12.7%(9/71),17.8%(13/73) vs 39.2%(29/74),P<0.05],6 months after surgery,the incidence of scleral dissolution of study group 1 was significantly higher than that of study group 2 and study group 3[10.8%(8/74) vs 1.4%(1/71),1.4%(1/73),P<0.05].Conclusion Pterygium excision combined with amniotic membrane,corneal limbal stem cell transplantation can significantly improve corneal refractive state and reduce the incidence of scleral complications, thus is worthy of clinical promotion.%目的：探讨不同手术方式对原发性翼状胬肉患者角膜屈光及术后巩膜溶解并发症的影响。
不同手术方式治疗翼状胬肉对泪膜稳定性的影响刘杰;王艺;袁久民【摘要】· AlM:To compare the therapeutic effects of different surgical methods in treating pterygium patients and to observe tear film stability. <br> · METHODS: A total of 120 pterygium patients ( 120 eyes) were divided into three groups, each 40 cases (40 eyes).Data including SchirmerⅠtest (SⅠt), tear break-up time ( BUT) , corneal fluorescein staining ( CFS) were recorded preoperatively and postoperatively to evaluate the clinical efficacy of surgery and the effects of tear function changes. <br> ·RESULTS:There were no significant differences in BUT in group A before the operation and one month after operation.Groups B and C showed significant difference before and after operation, but differences were not statistically significant ( all P<0.05 ); One month after operation, there was significant difference in CFS among group A, B and C (P<0.05), but the difference was not satistically significant between groups B and C; After 3mo, BUT in group A was not significant difference compared with the preoperative; but there was significant difference in groups B and C (P<0.05).When <br> compared it between groups B and C, there showed no significant difference; Group A showed no significant difference in SⅠt compared with preoperative, SⅠt of groups B and C were significant differences compared with preoperative (P<0.05), but no significant difference between the two groups;After 3mo, CFS of preoperative group A and group B and group C had no significantdifference. After 10mo follow - up, there was axsignificant difference( P<0.05 ) in recurrence rate in group A comparing with groups B and C, there were differences between groups B and C, but no statistically significant.Surgery is more likely to relapse in summer than in winter.<br> ·CONCLUSlON: Pterygium excision combined with self-corneal limbal stem cell transplantation and Tenon capsule closed is an ideal surgical to reduce the recurrence and improve tear film function to some extent.%目的：评价不同手术方式治疗翼状胬肉的效果，并观察其对泪膜稳定性的影响。
・1670・浙江临床医学2019年12月第21卷第12期・诊勺台分析・两种手术方式治疗翼状驚肉的疗效及对泪膜功能的影响阴洁陈耀祖辛延峰【摘要】目的观察翼状羯肉切除联合角膜缘干细胞移植与联合羊膜移植术后的疗效及对泪膜功能的影响。
方法回顾性分析2014年9月至2018年9月期间收治的122例原发性翼状將肉患者，根据不同的手术方式，分为A组和B组。
A组为角膜缘干细胞移植术组（58例，58眼），B组为羊膜移植术组（64例，64眼）。
术后随访1年，以泪膜破裂时间（BUT）、泪液分泌试验（SIT）及复发率作为分析统计指标。
结果患者行手术1年后，A组患者中复发4例（6.8%）,B组患者中复发8例（12.5%）,差异有显著性（P<0.05）：A、B两组术后1、3个月BUT、SIT均较术前减少，差异有显著性（P<0.05）o A、B两组组间比较，术后1个月B组BUT.SIT均较A组长，有显著差异性（P<0.05）;但术后3个月A、B组BUT、SIT无显著差异性（P-0.064）o两组术后1、3个月角膜散光度较术前均明显降低，有显著差异性（P<0.05）,但两组间角膜散光度变化无显著性差异（P>0.05）,结论翼状將肉切除联合角膜缘干细胞移植与联合羊膜移植术均可取得良好的临床疗效，改善外观，且降低患者的角膜散光，但A组复发率更低。
两者术后3个月内泪膜功能均有影响，术后3个月泪膜功能逐渐恢复，但B组术后早期对泪膜功能的影响小于A组。
【关键词】翼状將肉角膜缘干细胞羊膜移植泪膜[Abstract]Objective To investigate the efficiency and tear film fiinction of pterygium excision with limb a l stem cell transplantation and with amnion transplantation.Methods An analysis was done including122patients with primary pterygium who undenvent surgery in the Affiliated Hospital of Hangzhou Normal University from September2014to September2018.The patients were randomly divided into two group according to the different surgical methods.In group A,58cases（58eyes）received pterygium excision with limbal stem cell transplantation.In group B,64patients （64eyes）received pterygium excision with amnion transplantation.The patients were followed up for one year after ope ration.The tear film breakup time（BUT）,SIT test and the recurrence rate were respectively recorded.Results With one year4cases（6.8%）were recurred in group A, 8cases（12.5%）were recurred in group B,there were significant difference（P<0.05）.BUT and SIT were shortened in both groups at1month and3months post-operation,and the differences were significant（P<0.05）.BUT and SIT on group B was longer than the group A1month,the difierence was significant（P<0.05）,while for the two groups BUT and SIT3months after surgery,there was no significant difference（P=0.064）. Conclusion Pterygium excision with limbal stem cell transplantation and with amnion transplantation has good prognosis,but the former has lower recurrence rate.The two different surgical methods affect tear film fiinction at the early postoperative stage.Tear film fiinction returns to preoperative levels 3months after surgery.Influence of pterygium excise on with amnion transplantation on Rinction of the tear film is less than that of pterygium excision w让h limbal stem cell transplantation at early postoperative stage.[Key words]Pterygium Limbal stem cell Amniotic membrane Transplantation Tear film原发性翼状鹫肉是临床多见的纤维血管增生性眼病。
两种手术治疗原发性翼状胬肉的效果及对泪膜功能的影响郭飞;宋锐;王亚平【摘要】目的探讨两种手术治疗原发性翼状胬肉的效果及对泪膜功能的影响.方法选取该院2012年1月-2015年1月眼科收治的68例(82眼)原发性翼状胬肉患者为研究对象,将其随机分为观察组和对照组,每组患者各34例,观察组患者给予翼状胬肉切除联合自体角膜缘干细胞移植术,对照组患者给予翼状胬肉切除联合带蒂结膜瓣转移术.对比分析两组患者手术前后视力情况、角膜上皮平均修复时间、手术前后泪腺功能情况、术后并发症发生情况和随访6个月后复发情况.结果术后观察组患者视力正常及良好率为82.35％,显著高于对照组患者的52.94％ (P ＜0.05);观察组角膜上皮平均修复时间为(4.11±2.03)d,明显短于对照组患者的(6.20±3.13)d (P ＜0.05);两组患者术后基础泪液分析实验(SIT)、泪膜破裂时间(BUT)较术前均显著上升,两组患者手术前后SIT、BUT比较差异均有统计学意义(P ＜0.05);两组术后SIT、BUT比较差异无统计学意义(P＞0.05);观察组患者手术后并发症发生率为5.88％,显著低于对照组患者的17.65％(P＜0.05);经过6个月随访,观察组患者复发率为2.94％,显著低于对照组患者的26.47％(P＜0.05).结论针对原发性翼状胬肉的临床治疗,翼状胬肉切除联合自体角膜缘干细胞移植术与翼状胬肉切除联合带蒂结膜瓣转移术相比疗效相当,且均对患者泪腺功能有明显的改善作用,但前者术后视力提高更明显、眼表损伤及角膜上皮修复时间更短、复发率低且并发症少,更安全可靠.【期刊名称】《中国医学工程》【年(卷),期】2016(024)011【总页数】3页(P89-91)【关键词】原发性翼状胬肉;泪膜功能;基础泪液分泌试验【作者】郭飞;宋锐;王亚平【作者单位】河南省漯河市第三人民医院眼科,河南漯河462000;河南省漯河市第三人民医院眼科,河南漯河462000;河南省漯河市第三人民医院眼科,河南漯河462000【正文语种】中文【中图分类】R777.33原发性翼状胬肉是异常增生的纤维血管样组织的慢性炎症性病变，其确切发病原因及机制尚不明确，患病率达5%左右[1]，临床上常见于睑裂区的鼻侧，与结膜相连并向角膜表面生长，患者常产生异物感，也会导致视力明显下降，且影响美观，常给患者带来极大困扰[2]。
不同手术方式治疗翼状胬肉对角膜屈光状态的影响目的探讨翼状胬肉切除联合自体角膜缘干细胞移植和翼状胬肉切除联合羊膜移植对角膜屈光状态的影响。
方法将86例（86眼）翼状胬肉患者随机分为两组，每组43例，A组采用翼状胬肉切除联合自体角膜缘干细胞移植治疗，B组采用切除联合羊膜移植治疗，比较两组患者手术前后裸眼视力、角膜曲率和角膜散光度。
结果两组患者术后裸眼视力、角膜曲率较术前提高（P 0.05）。
结论翼状胬肉切除联合自体角膜缘干细胞移植和联合羊膜移植均为治疗翼状胬肉的有效的手术方法，临床可根据具体情况选择应用。
标签：翼状胬肉；自体角膜缘干细胞；羊膜；角膜屈光状态翼状胬肉是眼科常见的慢性结膜变性疾病，主要病理表现为球结膜组织呈三角形变性增厚，并向角膜生长、入侵[1]，不仅对患者的美观产生影响，还可引起眼部的不适症状，严重者覆盖瞳孔区，并可引起角膜屈光状态的改变，导致视力下降，给患者的生活质量带来严重影响。
翼状胬肉主要采用手术治疗，但角膜创面的恢复时间和最终角膜的散光程度因不同手术方式而有所差异[2]。
自2010年起，我院眼科采用翼状胬肉切除联合自体角膜缘干细胞移植术和翼状胬肉切除联合羊膜移植术治疗翼状胬肉患者86例86眼，并比较两种手术结果，以探讨两种手术方式角膜屈光状态的影响。
1资料与方法1.1一般资料86例翼状胬肉患者均为2010年2月～2013年2月在我院眼科住院治疗、均为初发单侧（鼻侧）翼状胬肉患者，头部侵入角巩膜缘2～5mm，按照数字随机法将86例86眼分为两组，每组43例43眼，A组男23例23眼，女20例20眼，年龄46～74岁，平均（58.6±9.2）岁；B组男25例25眼，女18例18眼，年龄49～76岁，平均（59.5±10.1）岁，两组患者一般资料差异无统计学意义，具有可比性。
所有患者均排除沙眼、过敏性结膜炎、慢性泪囊炎等其他眼科疾病，无结缔组织疾病、甲状腺功能亢进等全身性疾病，无眼科药物长期应用史。
