摘要
目的探讨50岁以上翼状胬肉患者术后复发的危险因素。方法采用回顾性研究方法,选择2021年3月至2024年3月在开封光明中医院住院并接受翼状胬肉切除联合自体角膜缘干细胞移植术(ALSCT)治疗的翼状胬肉患者85例。根据术后病理及临床诊断,其中80例为真性翼状胬肉(包括原发性及复发性),纳入术后复发危险因素分析;另5例为假性胬肉,予以描述但不纳入复发分析。根据术后1年的复发情况,将此80例真性翼状胬肉患者分为无复发组(62例)和复发组(18例)。观察患者临床特征,比较两组一般资料,采用Logistic回归分析50岁以上翼状胬肉患者术后复发的危险因素。结果所有85例手术患者中,翼状胬肉发生于鼻侧睑裂区83例(83只眼),颞侧2例(2只眼);年龄50~59岁66例(66只眼),≥60岁19例(19只眼)。在纳入复发分析的80例真性翼状胬肉患者中,患眼为左眼36例(36只眼),右眼44例(44只眼);年龄50~59岁63例(63只眼),≥60岁17例(17只眼);原发性翼状胬肉65例(65只眼),复发性翼状胬肉15例(15只眼)。无复发组和复发组的病程、角膜增生病变类型(原发性/复发性)、伴发剥脱综合征、伴发干眼症、工作环境、日间户外工作时长、术后3个月泪膜破裂时间(BUT)及角膜散光值比较,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,干眼症、日间户外工作时长、术后3个月BUT≤10 s是50岁以上翼状胬肉患者术后复发的独立危险因素(P<0.05)。结论50岁以上翼状胬肉患者病变多位于鼻侧,且以50~59岁原发性翼状胬肉患者为主。干眼症、日间户外工作时长、术后3个月BUT≤10 s是50岁以上翼状胬肉患者术后复发的独立危险因素,可为临床开展风险评估提供参考依据。
Objective To investigate risk factors for postoperative recurrence in patients aged≥50 years with pterygium.Methods Thisretrospective study included 85 patients who underwent pterygium excision combined with autologous limbal stem cell transplantation(ALSCT)at Kaifeng Guangming Traditional Chinese Medicine Hospital between March 2021 and March 2024.Postoperative pathological and clinical diagnosis confirmed 80 cases as true pterygium(including primary and recurrent).which were included in the recurrence risk analysis;the remaining 5 cases were pseudopterygium and were described but excluded from recurrence analysis.According to recurrence status at 1 year postoperatively.these 80 patients with true pterygium were divided into a non-recurrence group(n=62)and a recurrence group(n=18).Clinical characteristics were recorded.General data were compared between the two groups.and logistic regression was performed to identify independent risk factors for postoperative recurrence.Results Among all 85 surgical patients.pterygium occurred on the nasal side of the palpebral fissure in 83 cases(83 eyes)and on the temporal side in 2 cases(2 eyes).Among the 80 patients with true pterygium included in the recurrence analysis.the affected eye was the left eye in 36 cases(36 eyes)and the right eye in 44 cases(44 eyes).There were 63 cases(63 eyes)aged 50~59 years and 17 cases(17 eyes)aged≥60 years.Primary pterygium accounted for 65 cases(65 eyes).recurrent pterygium for 15 cases(15 eyes).Significant differences were observed between the non-recurrence and recurrence groups in disease duration.type of corneal proliferative lesion(primary/recurrent).concomitant exfoliation syndrome.concomitant dry eye disease.working environment.duration of daytime outdoor work.tear film breakup time(BUT)at 3 months postoperatively.and corneal astigmatism(P<0.05).Logistic regression analysis showed that dry eye disease.duration of daytime outdoor work.and BUT≤10 s at 3 months postoperatively were independent risk factors for postoperative recurrence in patients aged≥50 years with pterygium(P<0.05).Conclusion In patients aged≥50 years with pterygium.lesions are mostly located on the nasal side.and primary pterygium in patients aged 50–59 years predominates.Dry eye disease.longer duration of daytime outdoor work.and BUT≤10 s at 3 months postoperatively are independent risk factors for postoperative recurrence.providing a reference for clinical risk assessment.
作者
郑娜娜
刘德成
ZHENG Nana;LIU Decheng(Department of Ophthalmology,Kaifeng Guangming Traditional Chinese Medicine Hospital,Kaifeng Henan 475000,China;Department of Ophthalmology,Zhengzhou Seventh People’s Hospital,Zhengzhou Henan 450000,China)
出处
《临床研究》
2026年第2期61-64,共4页
Clinical Research
关键词
翼状胬肉
临床特征
术后复发
危险因素
pterygium
clinical characteristics
postoperative recurrence
risk factors
