目的 探究自体结膜移植连续缝合与间断缝合治疗翼状胬肉的临床疗效,并对术后角膜愈合、疼痛以及泪膜稳定性的影响进行分析。方法 收集2017年1月—2019年1月实施翼状胬肉切除联合带角膜缘干细胞自体结膜移植手术患者86例作为研究对象,根据平行对比法设定组别分为连续组和间断组,每组43例。连续组应用缝线连续缝合方式,间断组应用缝线间断缝合方式,观察两组患者术后角膜愈合程度、视觉疼痛评分以及泪膜稳定性。结果 连续组术后视觉疼痛评分、角膜愈合程度以及泪膜稳定性均优于间断组(P<0.05)。结论 自体结膜移植连续缝合较间断缝合治疗翼状胬肉可提升角膜愈合程度,降低术后疼痛感,并减少对泪膜稳定性的影响。
Objective To explore the effects of continuous suture and interrupted suture on corneal healing, pain degree, and tear film stability after autologous conjunctival transplantation for pterygium. Methods A total of 86 patients who underwent resection of pterygium and autologous conjunctival transplantation of corneal limbal stem cells from January 2017 to January 2019 were retrospectively analyzed. According to suture methods, the patients were assigned to continuous suture group (n=43) and interrupted suture group (n=43). The corneal healing degree, visual analogue scale score, and tear film stability were compared between the two groups. Results The visual analogue scale score, corneal healing degree, and tear film stability in the continuous suture group were better than those in the interrupted suture group (P<0.05). Conclusion After resection of pterygium and autologous conjunctival transplantation, continuous suture can improve corneal healing degree, relieve pain, and produce less impact on tear film stability.
[1] 张晓萍 .翼状胬肉的发病机制及治疗研究进展[J].齐鲁医学2016, 311) 115-117.
[2] 黄耀忠,兰小川.翼状胬肉切除联合自体结膜移植术后角膜像差及眼前节参数变化的临床研究[J].中华眼科医学杂志(电子版),2018,8(5):223-228.
[3] 朱伟,沈桢.四点固定式连续缝合法治疗翼状胬肉的临床研究[J].现代中西医结合杂志,2016,24(33):3729-3731.
[4] 张高明. 翼状胬肉三种手术治疗方法复发率的比较[J].南通大学学报(医学版)2015,3(3):239-240.
[5] 吴小军,高丰.改良的结膜瓣移植在翼状胬肉显微手术中的应用观察[J].中华显微外科杂志,2014,35(6):508-510.
[6] 李科毅,温杏芳,付浩祥,等.缝针侧刃代替线剪在翼状胬肉切除联合自体结膜瓣移植手术中的应用[J].中国医学创新,2017,14(9):70-73.
[7] 曾敦征. 自体血联合热凝切口运用于翼状胬肉切除手术的临床观察[J].中外医学研究,2016,30(30):21-23.
[8] 汤如,施光明,刘志芳,等.逆行撕除翼状胬肉联合角膜缘干细胞连续缝合移植手术的临床分析[J].中国医疗美容,2019,9(6):46-50.
[9] 陶丽惠,宋峰伟.翼状胬肉切除联合自体结膜瓣移植术中两种缝合方式对术后角膜愈合及疼痛分析[J].国际眼科杂志,2017,17(10):1960-1962.
[10] 李斌,牛燕,李超,徐庆.翼状胬肉切除联合自体结膜瓣移植手术中2种不同缝合方法对泪膜稳定性的影响[J].新乡医学院学报,2014,31(9):732-734.