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目的观察大范围胬肉切除联合新鲜羊膜移植术在治疗巨大翼状胬肉的临床疗效。方法显微镜下行大范围翼状胬肉切除联合新鲜羊膜移植术63例(67眼),观察术后胬肉复发及眼表修复情况。结果术后早期均有不同程度的结膜及植片充血、水肿和异物感,未见明显排斥反应发生,无感染。6周左右羊膜吸收,血管化完成,透明、光滑、稍显苍白,难与自身结膜区分开正常的,美容效果好。羊膜植片成活63眼,4眼植片溶解滑落。术后随访观察10～30个月,5眼复发,62眼治愈,复发率为7.4%。结论大范围翼状胬肉切除联合新鲜羊膜移植治疗巨大翼状胬肉能良好促进眼表的修复,有效降低胬肉的复发,手术安全性高;且新鲜羊膜取材方便,手术操作简单,有利于基层医院开展。
Objective To observe the clinical effect of large-scale pterygium excision combined with fresh amniotic membrane transplantation in the treatment of giant pterygium. Methods A total of 63 cases (67 eyes) underwent a large-scale pterygium resection combined with fresh amniotic membrane transplantation under microscope. The recurrence of pterygium and ocular surface repair were observed. Results There were different degrees of conjunctival and engraftment congestion, edema and foreign body sensation in the early postoperative period. No obvious rejection occurred and no infection was found. About 6 weeks amniotic absorption, vascularization completed, transparent, smooth, slightly pale, hard to distinguish itself from the normal conjunctiva, cosmetic effect is good. Survival of amniotic membrane 63 eyes, 4 eyes were dissolved and slipped. Follow-up postoperatively observed 10 to 30 months, 5 eyes relapsed, 62 eyes were cured, the recurrence rate was 7.4%. Conclusion A large range of pterygium resection combined with fresh amniotic membrane transplantation for the treatment of huge pterygium can promote ocular surface repair, effectively reduce the recurrence of pterygium, high operation safety; and fresh amniotic membrane is easy to take, the operation is simple, is conducive to the primary hospital Carry out.