| 摘要: |
| 目的 评估纤维蛋白胶（fibrin glue，FG）联合角膜缘干细胞移植在翼状胬肉治疗中的效能及安全性。方法 将50例原发性鼻侧翼状胬肉患者根据胬肉侵犯角膜的面积配对分为两组，每组25 例、25 眼。切除胬肉后，取患眼颞上方球结膜瓣覆盖于巩膜裸露区，实验组25 眼用FG 固定植片，对照组25 眼用10-0 尼龙线固定植片。于术后第1、3、7、14 天及1、2、6 个月对患者进行随访，观察手术耗时、患者术后不适症状、复发率及并发症等指标。结果 FG 组平均手术耗时明显短于缝线组（P＜0.01）且其各项术后不适症状均较缝线组轻（均P＜0.01）。至随访6 个月时FG 组无一例胬肉复发，缝线组复发1 例，两组复发率及并发症发生率的差异均无统计学意义（均P ＞0.05）。结论 在翼状胬肉切除联合角膜缘干细胞移植术中使用FG 可替代手术缝线，该法在缩短手术时间的同时还可减轻患者术后症状，长期随访结果令人满意，值得在临床上推广。 |
| 关键词: 纤维蛋白胶 缝线 翼状胬肉 角膜缘干细胞 |
| DOI： |
| 分类号: |
| 基金项目:浙江省医药卫生科技计划 |
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| Limbal stem cell transplantation with fibrin sealant in treatment of pterygium |
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GONG Jinwen, JIANG jin
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Zhejiang Provincial People’s Hospital
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| Abstract: |
| Objective To evaluate the efficacy and safety of fibrin sealant used for limbal stemcell transplantation in patients undergoing pterygium surgery. Methods Fifty patients (50 eyes) with primary nasal pterygiumunderwent pterygiumexcision with limbal stem cell transplantation. The patients were divided into two groups and each group contained 15 males and 20 females. Limbal stem cells taken fromsuperotemporal limbus were used to cover the bare sclera after pterygium excision. In one group the transplant was attached to the sclera with fibrin sealant (study group) and the other group with nylon 10-0 sutures (control group). The patients were followed up on d1, 3, 7 and14 then on months 1, 2 and 6. The main outcome measures included operating time, postoperative symptoms, graft success rate, recurrence rate and complications. Results The average operating time was significantly shorter (P＜0.001) and postoperative symptoms were fewer in study group than those in control group. No recurrence was observed in study group and the recurrence rate was 4%(1/25) in control group after 6-month follow- up (x2=1.020, P=0.312). There was no significant difference between two groups in complications including transplant loss, transient transplant edema, transplant overlying, nasal conjunctival fibrosis and graft shrinkage (P＞0.05). Conclusion Resultsmshow that fibrin sealant can replace sutures for attaching conjunctival autograft in primary pterygium surgery with satisfactory safety and effectiveness. |
| Key words: Fibrin glue Suture Pterygium Limbal stemcells |
