改良带结膜瓣角膜缘上皮移植在翼状胬肉手术治疗中的应用<br />-《中国美容医学》

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Title:: Application and Cosmetic Effects of Modified Corneal Limbal Epithelial
Transplantation with Conjunctival Flap in the Surgical Treatment of Pterygium

文章编号:: 1008-6455（2020）10-0040-03

作者:: 朱玲

Author(s):: ZHU Ling

关键词:: [关键词]翼状胬肉; 结膜瓣移植术; 角膜缘干细胞; 美容效果

Keywords:: Key words: pterygium; conjunctival flap transplantation; limbal stem cells; cosmetic effect

分类号:: R622

文献标志码:: A

摘要:: [摘要]目的：研究改良带结膜瓣角膜缘上皮移植在翼状胬肉手术治疗中的美容效果。方法：选取2018年1月-12月笔者医院行
手术治疗的82例（82眼）翼状胬肉患者临床资料进行回顾性分析，根据手术方案不同分为改良组47眼和常规组35眼，两组均
给予带结膜瓣角膜缘上皮移植手术，其中常规组自翼状胬肉头部前0.5mm开始剥离并剪除胬肉组织，改良组采用潜行分离和
逆行撕除法清除角膜上胬肉组织，比较两组术后主观症状、眼表结构和功能、美容效果及患者满意度。结果：两组术后眼
部异物感、流泪及疼痛评分均随时间逐渐降低，组内各时间差异显著，差异有统计学意义（P ＜0.05）；且改良组术后1d、
3d和7d时眼部异物感、流泪及疼痛评分均低于常规组，差异有统计学意义（P ＜0.05）。两组术后1d和7d时SIt较术前明显升
高，BUT较术前明显降低，且改良组术后1d和7d时SIt低于常规组，BUT高于常规组，差异有统计学意义（P ＜0.05）。改良
组术后美容效果明显优于常规组，两组恢复优良率分别为93.62%和74.29%，差异有统计学意义（P ＜0.05）。改良组术后外
观恢复满意度明显优于常规组，差异有统计学意义（P ＜0.05）；两组间服务态度、治疗过程及功能恢复满意度比较差异无
统计学意义（P ＞0.05）。结论：改良带结膜瓣角膜缘上皮移植治疗翼状胬肉可减轻患者术后不适，维持眼表结构和功能稳
定，促进外观恢复并提升患者满意度。

Abstract:: Abstract: Objective To study the cosmetic effects of modified corneal limbal epithelial transplantation with conjunctival flap in
the surgical treatment of pterygium. Methods The clinical data of 82 patients (82 eyes) with pterygium who underwent surgery
in our hospital from January 2018 to December 2018 were selected for retrospective analysis. According to the different surgical
regimens, they were divided into modified group (47 eyes) and routine group (35 eyes). Both groups were given corneal limbal
epithelial transplantation with conjunctival flap, and routine group was stripped from 0.5mm before the head of the pterygium
and cut off the pterygium tissues, and modified group applied undermining dissection and retrograde tearing to remove the
corneal pterygium tissues. The postoperative subjective symptoms, ocular surface structure and function, cosmetic effects and
patient satisfaction were compared between the two groups. Results The scores of postoperative ocular foreign body sensation,
tearing and pain in the two groups were gradually decreased with time, the differences were statistically significant (P ＜0.05).
The scores of ocular foreign body sensation, tearing and pain were observation group at 1d, 3d and 7d after operation in
modified group were lower than those in routine group (P ＜0.05). The SIt in the two groups at 1d, and 7d after operation was
significantly increased (P ＜0.05). While the BUT was significantly decreased (P ＜0.05). And the SIt in modified group was
lower than that in routine group at 1d and 7d after operation, while the BUT was higher than that in routine group (P ＜0.05).
The postoperative cosmetic effects in modified group were significantly better than those in routine group, and the excellent and
good rates of recovery were 93.62% and 74.29% (P ＜0.05). The satisfaction of postoperative appearance recovery in modified
group was significantly better than that in routine group (P ＜0.05), and there were no significant differences in satisfaction
towards service attitude, treatment process and functional recovery between the two groups (P ＞0.05). Conclusion Modified
corneal limbal epithelial transplantation with conjunctival flap for pterygium can reduce postoperative discomfort, maintain
ocular surface structure and function stability, promote appearance recovery and improve patient satisfaction.

《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

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