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

Effect of two different suture methods on the degree of pain and corneal epithelium healing condition in pterygium excision combined with autologous conjunctival flap graft transplantation

摘要:

目的：研究间断缝合与连续加锁缝合对翼状胬肉切除联合自体结膜瓣移植术后角膜愈合及疼痛评分的影响。

方法：回顾性系列病例研究。收集2015-06/2016-06于湖州师范学院附属第一医院行翼状胬肉切除联合自体结膜瓣移植手术治疗的患者92例92眼，根据术中结膜瓣缝合方式不同分为两组，A组48眼采用间断缝合法，B组44眼采用连续加锁缝合法，采用视觉模拟评分法(VAS)评价其术后2h，1d，1wk时疼痛情况以及采用荧光素钠染色分别于术后1d，1wk评价患者角膜上皮愈合情况。

结果：B组术后2h的VAS疼痛评分与A组相比，差异无统计学意义(P>0.05)； 但B组术后1d，1wk的VAS疼痛评分明显低于A组，差异有显著统计学意义(P<0.01)。B组术后1d角膜上皮愈合评分(4.04±1.46分)与A组(4.30±1.42分)比较，差异无统计学意义(P>0.05)。但B组术后1wk角膜上皮愈合评分(0.54±0.32分)与A组(0.86±0.34分)比较，差异有统计学意义(P<0.05)。

结论：在翼状胬肉切除联合自体结膜瓣移植术中，与间断缝合法相比，采用连续加锁缝合法能够部分缓解患者术眼的疼痛症状，有助于角膜创口的愈合。

Abstract:

AIM: To assess the effect of two different suture methods on the degree of pain and corneal epithelium healing condition after pterygium excision combined with autologous conjunctival flap graft transplantation.

METHODS: Retrospective case-series study. According to the suture method, a total of 92 patients(92 eyes)with pterygium who received treatment in the First Affiliated Hospital of Huzhou University from June 2015 to June 2016 were divided into two group. There were 48 patients(48 eyes)in Group A were received intermittent suture, and 44 patients(44 eyes)in Group B were received continuous interlocking suture. The degree of pain after surgery were evaluated between the two groups at 2h, 1d and 1wk after surgery by visual analogue score(VAS). The healing status of corneal epithelium were observed between the two groups at 1d and 1wk after surgery by fluorescent staining.

RESULTS: There was no significant difference in the average pain value 2h after surgery between Group A and Group B(P>0.05). The average pain values 1d and 1wk after surgery in Group B was lower than that in Group A respectively(P<0.01). Mean scores of corneal epithelium healing condition at 1wk were significantly better in Group B than in Group A(0.54±0.32 vs 0.86±0.34, P<0.05), while not significantly different at 1d after the surgery(4.04±1.46 vs 4.30±1.42, P>0.05).

CONCLUSION: Compared to intermittent suture, continuous interlocking suture can release pain response after pterygium excision combined with autologous conjunctival flap graft transplantation and promote the healing status of corneal epithelium.