两种手术治疗翼状胬肉术后泪膜稳定性观察

摘要

目的：评价两种不同手术方法治疗翼状胬肉对泪膜稳定性的影响。方法选取翼状胬肉患者60例60眼随机分为A、B两组，各30例30眼，A组行翼状胬肉切除联合羊膜移植术，B组行翼状胬肉切除联合角膜缘干细胞移植术，比较两组间术前、术后泪液分泌试验（Schirmerl试验）、泪膜破裂时间（BUT）、泪液羊齿状物试验（TFT），评估手术对泪膜稳定性的影响。结果 Schirmerl试验：A组和B组术后与术前相比差异均无显著性(P>0.05)，A组与B组比较差异无显著性(P>0.05)。BUT：A组和B组术后与术前相比差异均有显著性(P<0.05)，术前1d、术后2周、术后4周数值A组与B组比较差异无显著性(P>0.05)；术后12周B组BUT较A组改善明显，差异有显著性(P<0.05)。 TFT：A组和B组术后与术前相比差异均有显著性(P<0.05)，A组与B组比较差异无显著性(P>0.05)。结论翼状胬肉切除联合角膜缘干细胞移植术与翼状胬肉切除联合羊膜移植术，两种手术方式术后泪膜稳定性较术前均有改善；两者相互比较，术后早期泪膜稳定性改善无明显差异，但3个月后前者对泪膜改善更佳。%Objective To observe on the tear film stability of two different surgical method in the treatment for pterygium. Methods Select 60 patients with pterygium 60 eyes were randomly divided into A,B two groups,each 30 cases (30 eyes),A group of patients with pterygium excision with amniotic membrane transplantation,group B patients pterygium excision combined limbal stem cell transplantation,Comparison between the two groups of preoperative and postoperative tear secretion test (Schirmerl test), breakup time of tear film (BUT),tear the fern test (TFT),to assess the effect of operation stability of tear film. Results Schirmer l test:group A and group B after surgery had no significant difference compared with preoperative (P>0.05),there was no significant difference compared with group B group A (P>0.05). BUT:group A and group B compared with preoperative postoperative differ-ences were significant (P<0.05),preoperative 1 day,2 weeks after operation,postoperative 4 weeks numerical group A there was no significant difference compared with group B(P>0.05);BUT after 12 weeks of group B was improved obviously,group A had signifi-cant difference(P<0.05). TFT:group A and group B compared with preoperative postoperative differences were significant(P<0.05), there was no significant difference compared with group B group A(P>0.05). Conclusion Pterygium excision combined limbal stem cell transplantation and pterygium excision with amniotic membrane transplantation ,two kinds of operation method to possess the ability to improve postoperative stability appears more preoperative;A comparison between the two,early postoperative appears to improve stability has no obvious difference,but after 3 months of appears to improve the former is better.