目的：比较人纤维蛋白粘合剂与传统显微缝线联合角膜缘干细胞移植术治疗翼状胬肉的疗效和特点。

方法：采用前瞻性随机研究，收集2016-06/2017-09在我院诊断为原发性翼状胬肉的患者148例148眼，依据患者意愿分为观察组与对照组。观察组行人纤维蛋白粘合剂联合角膜缘干细胞移植术，共74例74眼； 对照组行连续锁边缝合联合角膜缘干细胞移植术，共74例74眼，记录每位患者的手术时间。患者术后1、3d，1wk，1、3、6mo时复诊，记录所有患者1wk内眼部疼痛程度评分及术后并发症。

结果：观察组患者手术时间为15.23±2.26min，对照组手术时间为28.22±2.70min，使用人纤维蛋白粘合剂固定结膜瓣的手术时间短，差异有统计学意义(t=-31.75，P<0.01)。观察组患者术后1、3、7d眼部疼痛程度评分分别为0.62±0.69、0.34±0.50、0.16±0.37分，对照组为1.15±0.92、0.54±0.60、0.18±0.38分，术后1wk内眼部疼痛逐渐改善，差异有统计学意义(P<0.01)； 术后各时间点两两比较差异均有统计学意义(P<0.01)； 相同时间点比较，术后1、3d观察组的患者眼部疼痛评分明显低于对照组，差异有统计学意义(t=-3.94、-2.22，均P<0.05)，术后7d时无明显差异(t=-0.22，P>0.05)。观察组术后复发2眼，复发率为2.7%，对照组术后复发4眼，复发率为5.4%，两组患者复发率差异无统计学意义(P>0.05)； 两组患者术后随访6mo，观察组患者术后5眼(6.8%)发生并发症； 对照组6眼(8.1%)发生并发症，两组患者差异无统计学意义(χ²=16.32，P>0.05)。

结论：使用人纤维蛋白粘合剂治疗翼状胬肉可以缩短手术时间，减少术后不适，术后反应轻，移植物脱位少，术后无需拆线，效果更好。

METHODS: A prospective randomized controlled study was conducted. A total of 148 eyes of 148 patients with pterygium were involved in the study from June 2016 to September 2017. All patients were divided into two groups receiving 10-0 vicryl sutures or human fibrin sealant respectively. Patients were seen on postoperative 1, 3d, 1wk, 1, 3, and 6mo after surgery. The duration of surgery, level of patient discomfort, pterygium recurrence, and complications were retrospectively analyzed between two groups.

RESULTS: The duration of surgery in observer group was 15.23±2.26min and 28.22±2.70min in control group, the difference was statistically significant(t=-31.75, P<0.01). One week later, the level of patient discomfort at 1, 3 and 7d after surgery were 0.62±0.69, 0.34±0.50, 0.16±0.37 in observation group, and the level of patient discomfort were 1.15±0.92, 0.54±0.60, 0.18±0.38 in control group, and the difference were statistically significant in observer group and control group(P<0.01); comparison between any two means in either group was significantly different(P<0.01). There were significant difference between the two groups on postoperative 1, 3d after surgery(t=-3.94, -2.22; P<0.05), and there was not significant difference between the two groups on postoperative 7d after surgery(t=-0.22, P>0.05). Two eyes(2.7%)were recurrent on postoperative 6mo after surgery in observation group and 4 of 74 eyes(5.4%)in control group, demonstrated no significant differences(χ²=24.2, P>0.05). Five of 74 eyes(6.8%)were with complications in observation group and 6 of 74 eyes(8.1%)in control group, demonstrated no significant differences(χ²=16.32, P>0.05).

CONCLUSION: The duration of surgery, patient discomfort level were reduced markedly, as less flap dislocation and postoperative reaction with human fibrin sealant compared with 10-0 vicryl sutures. A good result can be obtained by using the human fibrin sealant in the surgery of pterygium.