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表皮生长因子应用于翼状胬肉术后角膜上皮修复的临床研究

发布时间:2006-10-13 00:00 点击:376 字号:

表皮生长因子应用于翼状胬肉术后角膜上皮修复的临床研究
姚晓明 邓宏伟  罗康怡  翁宏  黎明
暨南大学附属深圳眼科医院,深圳,518001
通讯作者:姚晓明  xmyeye@163.com
 
〔摘要〕
目的 对翼状胬肉患者,采用单纯翼状胬肉摘除联合巩膜暴露术,术后应用重组人表皮生长因子衍生物滴眼液,观察术后的临床反应和角膜上皮缺损区的愈合过程,评价外源性表皮生长因子对角膜上皮修复的促进作用。
方法 对72例(72只眼)翼状胬肉者实施单纯翼状胬肉摘除联合巩膜暴露术,术后患者随机分为2组,实验组42例(42只眼)从术后第一天起给予0.3%氧氟沙星滴眼液+金因舒滴眼液术眼每日各四次;对照组30例(30只眼)从术后第一天起给予0.3%氧氟沙星滴眼液术眼每日四次,分别观察2组患者术后的疼痛、畏光、异物感、眼干和角膜上皮修复等5项指标。角膜上皮修复指标按角膜上皮完全愈合的时间记录,疼痛、畏光、异物感、眼干等指标按无、有、轻、中、重分别记为0、1、2、3、分。术后1天、2天、3天、1周、2周观察术后反应并评分。
结果 一般情况:实验组与对照组在年龄、性别等方面没有统计学差异(P>0.05)。翼状胬肉术后的症状指标:疼痛、畏光、异物感、眼干等指标,实验组患者术后第1天、2天、3天与对照组比较,差异有统计学意义(P<0.05)。在术后1周、2周时,两组患者的疼痛、畏光、异物感、眼干等指标无统计学差异(P>0.05)。翼状胬肉术后角膜上皮修复的客观体征指标:实验组患者的翼状胬肉术后角膜上皮的完全修复时间为2.14天,而对照组的角膜上皮完全修复时间为3.43天,实验组明显早于对照组,两组间有显著统计学差异(P<0.05)。
结论  翼状胬肉者实施单纯翼状胬肉摘除联合巩膜暴露术后,使用重组人表皮生长因子衍生物滴眼液,能够明显减轻术后早期的疼痛、畏光、异物感、眼干等眼表刺激症状,安全有效、无毒副作用,并能显著缩短角膜上皮愈合的时间,有助于单纯翼状胬肉摘除联合巩膜暴露术后角膜上皮机械性损伤的修复。
 
 
Therapeutic effect observation of epidermal growth factor on the healing of corneal epithelium after operation of pterygiun      YAO Xiao-ming,DENG Hong-wei,Luo Kang-yi,Weng-hong,LI Ming.
Shenzhen Eye Ophthalmic Center of Jinan University Medical College, Shenzhen,China, 518001.
Corresponding author: YAO Xiao-ming, Email: xmyeye@163.com
 
[Abstract]  Objective  To evaluate the therapeutic effect and observe the clinic menifetation of epidermal growth factor on the healing of corneal epithelium after pterygium excision ­­-“bare-sclera” procedure.  Methods:  72 patients with pterygium were performed the pterygium excision ­­—“bare-sclera” procedure. A randomized study enrolled 42 patients for treated group with therapy of rhEGF eyedrops+0.3%Ofloxacin eyedrops Qid and 30 patients for controlled group with therapy of 0.3%Ofloxacin eyedrops Qid after operation. Pain, photophobia, foreign body sensaqtion, dryness and healing time of epithelium were observed at 1 day, 2 days, 3 days, 4 days, 1 week, 2 weeks postoperatively. The healing time of epithelium was scored the days of healing. Pain, photophobia, foreign body sensaqtion, dryness were scored as 0 ,1 ,2 or 3 respectively according to negative, slight, moderate or severe degree at the same time.  Results: There was no difference on the age and sex between the treated group and controlled group. Pain, photophobia, foreign body sensaqtion, dryness of treated group were slighter than controlled group at 2, 3 and 4 days postoperatively(P<0.05). There were no difference on the pain, photophobia, foreign body sensaqtion, dryness at 1 day, 1 week and 2 weeks between the treated group and controlled group. The epithelial healing time of treated group was 2.14 days, that of controlled group was 3.43 days. The treated group was faster than controlled group. There were significant difference on the healing time between two group.  Conclusion  rhEGF eyedrops may relieve early pain, photophobia, foreign body sensaqtion, dryness after pterygium excision ­­-“bare-sclera” procedure and shorten the healing time obviously, beneficial to epithelium recovery from mechanical injury.