两种麻醉方式在胬肉切除加角膜缘干细胞移植术的效果对比
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Comparison of the effects of two different anesthesias utilized in pterygium excision and limbal stem cell transplantation
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    摘要:

    目的:探讨表面麻醉及表面麻醉联合局部浸润麻醉两种麻醉方式下行翼状胬肉切除联合角膜缘干细胞移植的手术效果。

    方法:前瞻性研究。对48例52眼行胬肉切除联合角膜缘干细胞移植手术治疗的初发性翼状胬肉患者,按数字表法随机分为A,B两组,A组23例26眼行表面麻醉加20g/L利多卡因结膜下浸润麻醉,B组25例26眼行单纯表面麻醉。两组均行胬肉切除联合角膜缘干细胞移植术。主要观察手术时间、手术疼痛程度、植片的匹配程度、结膜下出血及术后半年复发率。

    结果:B组手术时间较A组短,差异有统计学意义(P<0.05); B组结膜下出血率少,手术疼痛、植片匹配度两组间差异无统计学意义(P>0.05)。随诊半年,A组有1例1眼复发,B组无复发,两组间复发情况差异无统计学意义(P>0.05)。

    结论:表面麻醉完全满足胬肉切除联合自体角膜缘干细胞移植术的要求,且能清晰地切除病变组织,使植床与植片更好匹配,缩短手术时间,减少术中出血。

    Abstract:

    AIM: To investigate the surgery effectiveness between topical anesthesia and topical combined local anesthesia in pterygium excision with limbal stem cell transplantation.

    METHODS: It was a prospective clinical study. Totally 48 primary pterygium cases(52 eyes)who needed pterygium excision combined with limbal stem cell transplantation were divided into group A and group B according to random number table. 23 cases(26 eyes)in group A received topical anesthesia combined local anesthesia of 20g/L lidocaine subconjunctival infiltration, while 25 cases(26 eyes)in group B underwent topical anesthesia simply. All patients were performed the same operation mode. The main survey indexes included operative time, anesthesia effectiveness, the matching degree of graft, subconjunctival hemorrhage and recurrence rate 6 months after surgery.

    RESULTS: The operation time of group B was shorter than that of group A. There was significant difference between group A and group B(P<0.05). Patients in group B had less subconjunctival hemorrhage. There was no significant difference in paining and matching degree of graft between group A and group B(P>0.05). Followed up for 6 months, 1 case(1 eye)recurrence was found in group A, while none in group B. No statistical difference was noted between two groups with recurrence.

    CONCLUSION: Topical anesthesia is satisfied to be used in pterygium excision with autologous limbal stem cell transplantation. With the topical anesthesia, we can remove the pathological tissues clearly, match planting bed with graft better, make a shortened operative time and decrease operative blood loss.

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陈丽华,许福荣,伍雪芬,等.两种麻醉方式在胬肉切除加角膜缘干细胞移植术的效果对比.国际眼科杂志, 2013,13(3):599-600.

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  • 收稿日期:2012-10-14
  • 最后修改日期:2013-02-04
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