论著

连续锁边缝合联合角膜绷带镜在翼状胬肉手术中的应用

Application of continuous locking suture combined with corneal bandage contact lens in pterygium operation

:137-142
 
目的:探讨连续锁边缝合联合角膜绷带镜在翼状胬肉手术中应用的效果。方法:采用前瞻性随机对照临床研究。选取2018年1月到2021年6月期间在我院行翼状胬肉切除联合自体角膜缘结膜瓣移植术的患者132例180眼,按结膜瓣固定方式随机分为A、B两组,其中A组患者(64例90眼)行间断缝合固定法,B组患者(68例90眼)行连续锁边缝合法,术毕两组患者均给与配戴角膜绷带镜。比较两组患者的术后眼部疼痛程度评分、术后效果及并发症。结果:术后1、3 d,B组疼痛评分明显低于A组,差异有统计学意义(P<0.01);术后1、3、7 d两组间角膜染色评分差异无统计学意义(P>0.05);术前、术后3个月两组间泪膜破裂时间(breakup time of tear film,BUT)差异无统计学意义(P>0.05),但术后3个月组内的BUT较手术前有明显改善(P<0.05)。术前、术后2周两组间视力差异均无统计学意义(P>0.05),术后2周两组组内视力较手术前均有明显改善(P<0.05)。随访3个月,两组患者主要术后并发症包括胬肉撕除后浅层基质损伤延迟愈合、线结处结膜增生、结膜植片松脱等,并发症发生率两组相当。结论:采用连续锁边缝合联合配戴角膜绷带镜治疗翼状胬肉可以促进角膜创面的修复,减轻患者的术后刺激症状,提高患者术后舒适度;连续锁边缝合时需要适当增加缝线跨度,可减少术后结膜植片的松脱。
Objective: To investigate the effect of continuous locking suture combined with corneal bandage lens in the operation of pterygium. Methods: A prospective randomized controlled clinical trial was conducted. From January 2018 to June 2021, 132 patients (180 eyes) who underwent pterygium excision combined with autologous limbal conjunctival flap transplantation were randomly divided into group A and group B according to the fixation of conjunctival fla. The patients in group A (64 cases, 90 eyes) were treated with intermittent suture and fixation, and the patients in group B (68 cases, 90 eyes) were treated with continuous locking suture. Both groups were given corneal bandage lenses at the end of the operation. The postoperative ocular pain score, postoperative effect and complications were compared between the two groups. Results: The pain score in group B was significantly lower than that in group A at 1 and 3 d after operation (P<0.01), and there was no significant difference in corneal staining score between the two groups at 1, 3 and 7 d after operation (P>0.05). There was no significant difference in breakup time of tear film (BUT) between the two groups before and 3 months after operation (P>0.05), but the BUT at 3 months after operation in the group was significantly better than that before operation (P<0.05). There was no significant difference in visual acuity between the two groups before and 2 weeks after operation (P>0.05). The visual acuity of the two groups was significantly improved 2 weeks after operation (P<0.05). During the follow-up of 3 months, the main postoperative complications of the two groups included delayed healing of superficial matrix injury after pterygium avulsion, conjunctival hyperplasia, conjunctival graft loosening and so on. Conclusion: Continuous locking suture combined with corneal bandage lens in the treatment of pterygium can promote the repair of corneal wound, reduce the postoperative irritation symptoms and improve the postoperative comfort of patients. It is necessary to increase the suture span during continuous locking suture, which can reduce the loosening of conjunctival graft after operation.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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