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[摘要]
目的:评价翼状胬肉切除联合角膜缘干细胞移植术中,结膜植片两种缝合方法临床效果的差异。
方法:采用前瞻随机对照试验,将48例48眼初发翼状胬肉患者随机分为A,B两组,每组24例24眼,A组术中结膜植片采用连续锁边缝合法; B组术中结膜植片采用间断缝合法。术中记录结膜缝合时间,术后随访6mo,记录拆线所用时间及眼部刺激评分情况。
结果:术中平均植片缝合时间A组为14.05±2.30min,B组为19.34±2.12min,两组差异有统计学(P<0.01)。眼部刺激情况分值在术后第3d(1.32±0.60 vs 1.68±0.35)和第5d(0.87±0.24 vs 1.26±0.68),A组得分均明显低于B组(P均<0.05)。A组拆线所用时间为9.15±3.36min,B组拆线所用时间为12.61±3.89min,两组差异有统计学意义(P<0.01)。
结论:连续锁边缝合法提高了手术效率,减轻了术后的刺激症状,是一种安全高效的结膜植片缝合方法。
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[Abstract]
AIM: To compare the effects of continuous side whipstitch suture and interrupted suture in conjunctival autograft surgery after resection of primary pterygium.
METHODS: A comparative, prospective and randomized clinical trial was performed in 48 eyes of 48 patients with primary pterygium. All patients were randomly divided into two groups with 24 eyes of 24 patients in each group. In group A and B, continuous side whipstitch suture and interrupted suture were respectively adopted. The time spent in suture was recorded during surgery. The postoperative ocular discomfort and the time spent in taking out stitches were recorded during the 6-month follow-up.
RESULTS: The average surgical time was 14.05±2.30 minutes for group A and 19.34±2.12 minutes for group B(P<0.01). The ocular discomfort scale analysis showed a lower score in the 3rd (1.32±0.60 vs 1.68±0.35, P<0.05), 5th(0.87±0.24 vs 1.26±0.68, P<0.05)postoperative days in group A, compared with group B. The average time of removing stitches was 9.15±3.36 minutes in group A and 12.61±3.89 minutes in group B(P<0.01).
CONCLUSION: In the surgical management of primary pterygium, continuous side whipstitch suture can improve the surgical efficiency and decrease the ocular discomfort in the postoperative period. It proves to be an excellent option for conjunctival autograft attachment in primary pterygium surgery.
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