摘要
目的:探讨采用术前评分的方法选择翼状胬肉病例作为研究生眼科显微技术培养的安全性和可行性。方法:根据年龄、病变分期、类型(初发或复发)、长度及宽度等因素对翼状胬肉患者进行术前评分。将总分为5~7分的翼状胬肉患者58例(61眼)随机分成A、B组,行翼状胬肉切除联合球结膜转位术,A组30例(32眼)由有良好临床显微手术经验的住院医师和上级医师共同完成,B组28例(29眼)由规培研究生和A组的同一上级医师共同完成。术后随访6~12个月,观察比较两组患者的手术时间、角膜创面愈合时间、复发率、手术并发症的差异。结果:A、B两组患者的手术时间分别为(25.16±2.89)min、(33.38±3.62)min,A组短于B组(Z=-6.324,P=0.000)。A、B两组患者角膜创面愈合时间分别为(5.16±1.32)d、(5.28±1.49)d,两组比较差异无统计学意义(Z=-0.339,P=0.735)。A组有2眼复发,复发率为6.25%;B组有2眼复发,复发率为6.90%,两组复发率比较差异无统计学意义(χ2=0.010,P=0.919)。结论:从个体化出发,采用术前评分的方法选择适合的研究生参与翼状胬肉病例的手术,可以达到良好的手术效果,复发率低,未见明显手术并发症。
Objective : To discuss the safety and feasibility of ocular microsurgery skills training to graduate students by selecting pterygium cases based on preoperative scoring, nethods:Pterygium cases were scored based on their age, stage, type (primary or palindromia), length and width. 58 cases (61 eyes) who gained 5 to 7 scores were divided randomly into Group A and Group B, and then were applied pterygium excision combined with bulbar conjunctival flap transplantation. Group A, 30 cases (32 eyes), were operated by residents and their superior physician who had good microsurgery experience. Group B, 28 cases (29 eyes) were operated by graduate students and the same superior physician of group A. All patients had 6 - 12 months follow - up after surgery. Operation time, recovery time of cornea, recurrence rate and surgical complication of the two groups were analyzed. Results:The operation time of Group A was 25.16 ±2.89 min and Group B was 33.38 ±3.62 min, with the difference statistically significant( P 〈0.05 ). Group At recovery time of cornea was 5.16 ±1.32 d and Group B was 5.28 ±1.49 d, and there was no significant difference in recovery time of cornea between the two groups ( P 〉0.05). Relapse of pterygium was observed in 2 eyes of Group A (6. 25 % ) and 2 eyes in Group B ( 6.90% ) , and there was no significant difference of recurrence rate between the two groups ( P 〉 0.05 ). Conclusion : Based on individualization, preoperative scoring applied to pterygium cases in which graduate students are suitable to participate in, has a satisfactory operation effect, with low recurrence rate, and no obvious surgical complications.
作者
徐朝阳
刘光辉
潘铭东
柯小清
XU Zhaoyang LIU Guanghui PAN Mingdong KE Xiaoqing(Department of Ophthalmology, Fujian Traditional Chinese Medicine University Affiliated People's Hospital, Fuzhou 350004, Chin)
出处
《包头医学院学报》
CAS
2017年第10期111-113,共3页
Journal of Baotou Medical College
关键词
翼状胬肉
评分
研究生
眼科显微技术
Pterygium
Score
Postgraduate
Ophthalmological microsurgery skills