最近一年長庚醫院翼狀贅肉手術結果分析

Retrospective Surgical Result of Pterygium in Cgmh during Recent One Year

蔡瑞芳(Ray Jui-Fang Tsai) ； 李建興(Jiahn-Shing Lee)

《中華民國眼科醫學會會刊》 29卷2期 (1990/05) Pp. 762-769

https://doi.org/10.30048/ACTASOS.199005.0131

摘要

本文收集民國77年5月到78年4月間長庚醫院一年內翼狀贅肉手術的病例，以回溯方式統計各種手術的再發率、併發症、及藥物治療做比較。共收集695位病人，男334，女361，計798眼，其中以追踪3個月以上之病例294眼而言；施行鞏膜暴露法的有268眼，再發數為59(22.0%)；其中原發例的再發比率為20.3%(46/227)，再發例的為31.7%(13/41)。施行結膜移植法的有26眼，再發數為1眼(3.8%)；其中原發例的再發比率為0%(0/14)，再發例的為8.3%(1/12)。再發例的再發時間多較原發例為早，再發例多為術後1.5至2月，原發例為2至3月最多。術後藥物使用，鞏膜暴露法為steroid加Thiotepa或Mitomycin C（使用motomycin C的僅6例，均無再發）；結膜移植法則僅用steroid。在術後併發肉芽組織中，在鞏膜暴露法的有40例(14.9%)，在結膜移植法的有2例(7.7%)；併發鞏膜潰瘍的有2例，均為鞏膜暴露法所產生。本文結論使用結膜移植法將暴露的鞏膜蓋住，可減低術後的炎症反應，避免炎疫物質產生而刺激新生血管的迅速形成，以減低再發率。

並列摘要

A retrospective study of 294 eyes for the comparison of 2 major methods of pterygium management: group 1, using topic eye drops of fibroblast inhibitor (Thiotepa or Mitomycin C) after surgical removal of pterygium, and goup 2, covering the exposure wound area by autograft conjunctiva. Group 1: Thiotepa 262 eyes, Mitomycin C 6 eyes; totla 268 eyes. Group 2: 26 eyes.
In our study, the recurrent rate of post pterygium surgery in the group with conjunctival transplantation (3.8%) is lower than that in chamical therapy (20.3%), either in primary cases or recurrent cases; P＜0.05 in total cases. Post-op complications in conjunctival transplatation are K.S.P., granuloma, and congestion…etc, but beside the above complications there are more severe ones, such as scleral melting, ulcer…etc. in chemical therapy.
In general, the recurrent rate is related with surgical method, age of patient, & duration of treatment by antitumor drug; not related with location of pterygium, sex of patient, & experience of surgeon. And concerning the duration of Thiotepa treatment, the best effect is among 2 weeks to one month.

並列關鍵字

Pterygium ； Conjunctival autograft Transplantation ； Mitomycin C ； Thiotepa