自体角膜缘干细胞移植和羊膜移植治疗翼状胬肉的疗效及安全性

发布时间：2019-05-14 14:48

【摘要】：目的系统评估翼状胬肉切除联合自体角膜缘干细胞移植和胬肉切除联合羊膜移植两种手术方式治疗原发性或复发性翼状胬肉的有效性和安全性。方法数据库检索辅以手工检索国内外相关文献,采用Jadad量表对纳入研究进行质量评价,RevMan5.0软件进行异质性检验和Meta分析、敏感性分析,并评价是否存在发表偏倚。结果原发性翼状胬肉纳入24篇文献,共2 592只眼。复发性翼状胬肉纳入17篇文献,共1 294只眼。Meta分析结果显示:与羊膜移植相比,角膜缘干细胞移植在原发性翼状胬肉术后复发方面,差异有统计学意义〔RR=0.45,95%CI(0.35,0.58),P0.01〕。在复发性翼状胬肉术后复发方面,差异有统计学意义〔RR=0.36,95%CI(0.27,0.49),P0.01〕。在术后并发症方面,原发性翼状胬肉角膜缘干细胞治疗组总体的并发症发生率为10.3%(18/174只眼),羊膜移植组总体的并发症发生率为11.8%(19/161只眼),两组间并发症的发生率差异无统计学意义(Z=0.40,P=0.69)。复发性翼状胬肉角膜缘干细胞移植组总体的并发症发生率为11.8%(8/68只眼),羊膜移植组总体的并发症发生率为10.6%(7/66只眼),两组间并发症的发生率差异无统计学意义(Z=0.20,P=0.84)。结论翼状胬肉切除联合自体角膜缘干细胞移植在原发性或复发性翼状胬肉的术后效果优于胬肉切除联合羊膜移植,可减少复发率。
[Abstract]:Objective to evaluate the efficacy and safety of pterygium resection combined with autologous limbal stem cell transplantation and pterygium resection combined with amniotic membrane transplantation in the treatment of primary or recurrent pterygium. Methods Database retrieval was supplemented by manual retrieval of relevant literature at home and abroad. Jadad scale was used to evaluate the quality of the inclusion study. RevMan5.0 software was used for heterogeneity test, Meta analysis, sensitivity analysis, and evaluation of publication bias. Results the primary pterygium was included in 24 articles, with a total of 2592 eyes. Recurrent pterygium was included in 17 literatures with a total of 1 294 eyes. Meta-analysis showed that limbal stem cell transplantation was more effective than amniotic membrane transplantation in postoperative recurrence of primary pterygium. The difference was statistically significant (RR=0.45,95%CI (0.35, 0.58), P 0.01). There was significant difference in postoperative recurrence of recurrent pterygium (RR=0.36,95%CI, 0.49). In terms of postoperative complications, the overall incidence of complications in the primary pterygium limbal stem cell treatment group was 10.3% (18 鈮，

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