目的：观察大角膜缘移植瓣术在翼状胬肉中的应用效果。方法选取2013年1月至2014年12月我院眼科收治的100例（100眼）翼状胬肉患者为研究对象，根据随机数字表法随机分为对照组50例(50眼)和观察组50例(50眼)。观察组给予大角膜缘移植瓣术治疗，对照组给予小自体角膜缘移植瓣术。比较两组患者治疗前后的视力、屈光度、泪液基础分泌量及泪膜破裂时间；同时比较两组患者的治疗总有效率、复发率及并发症发生率。结果治疗前，两组患者的视力、屈光度、泪液基础分泌量及泪膜破裂时间比较差异均无统计学意义(P>0.05)；治疗后4周，观察组与对照组患者的上述观察指标分别为(0.72±0.07)、(0.97±0.65) D、(9.68±2.17) mm、(11.7±2.88) s和(0.49±0.10)、(1.70±0.48) D、(6.85±2.04) mm、(7.90±2.13) s，均较治疗前显著改善，差异均有统计学意义(P<0.05)，且观察组的改善程度优于对照组，组间比较，差异均有统计学意义(P<0.05)。观察组患者治疗有效率为96.0%(48/50)，明显高于对照组的78.0%(39/50)，差异有统计学意义(P<0.05)。随访13~37个月，观察组患者的复发率为2.0%(1/50)，对照组为18.0%(9/50)，观察组低于对照组，差异有统计学意义(P<0.05)。观察组术后并发症发生率为12.0%(6/50)，高于对照组的6.0%(3/50)，但差异无统计学意义(P>0.05)。结论采用大角膜缘移植术治疗翼状胬肉能够有效改善患者的视功能及泪膜稳定性，降低复发率，其具有疗效确切、安全性高等特点，值得临床推广应用。%Objective To observe the application of large corneal limbus transplantation flap technique in the treatment of pterygium. Methods A total of 100 cases (100 eyes) of patients with pterygium, who admitted to our hos-pital from January 2013 to December 2013, were selected as the research objects, and divided into 2 groups [the control group of 50 cases (50 eyes), the observation group of 50 cases (50 eyes)] according to the random number table method. The observation group was treated with large corneal limbus transplantation for the treatment of disc, and the control group was treated with small limbal autograft flap surgery. Before and after the treatment, the eyesight, diopter and tear secretion and appears burst time in the two groups were compared. At the same time, the total effective rate, recurrence rate and complication rates in the two groups also were compared. Results Before the treatment, there were no signifi-cant differences between the two groups of patients in the visual basis of eyesight, diopter and tear secretion and appears burst time (P>0.05); Compared with before the treatment, there were significant improvement 4 weeks after the treat-ment in the observation group [(0.72±0.07), (0.97±0.65) D, (9.68±2.17) mm, (11.7±2.88) s] and the control group [(0.49± 0.10), (1.70 ± 0.48) D, (6.85 ± 2.04) mm, (7.90 ± 2.13) s] in the above indexes (P<0.05), and the degree of the improve-ment of the observation group was significantly better than that of control group (P<0.05). The treatment effective rate in the observation group [96.0% (48/50)] was significantly higher than that in the control group [78.0% (39/50)], P<0.05. 13 to 37 months' follow-up showed that the recurrence rate of the observation group [2.0%(1/50)] was signifi-cantly lower than that of the control group [18.0% (9/50)], P<0.05. The incidence of postoperative complications of the observation group [12.0%(6/50)] was higher than that of control group [6.0%(3/50)], but there was no statistically significant difference (P<0.05). Conclusion The corneal limbus transplantation can effectively improve the visual function and appears stability, reduce the recurrence rate of patients with pterygium, which have curative effect and high security features, and is worthy of clinical application.
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