自體角膜緣干細(xì)胞移植和羊膜移植治療翼狀胬肉的療效及安全性
發(fā)布時(shí)間：2019-05-14 14:48
【摘要】：目的系統(tǒng)評(píng)估翼狀胬肉切除聯(lián)合自體角膜緣干細(xì)胞移植和胬肉切除聯(lián)合羊膜移植兩種手術(shù)方式治療原發(fā)性或復(fù)發(fā)性翼狀胬肉的有效性和安全性。方法數(shù)據(jù)庫(kù)檢索輔以手工檢索國(guó)內(nèi)外相關(guān)文獻(xiàn),采用Jadad量表對(duì)納入研究進(jìn)行質(zhì)量評(píng)價(jià),RevMan5.0軟件進(jìn)行異質(zhì)性檢驗(yàn)和Meta分析、敏感性分析,并評(píng)價(jià)是否存在發(fā)表偏倚。結(jié)果原發(fā)性翼狀胬肉納入24篇文獻(xiàn),共2 592只眼。復(fù)發(fā)性翼狀胬肉納入17篇文獻(xiàn),共1 294只眼。Meta分析結(jié)果顯示:與羊膜移植相比,角膜緣干細(xì)胞移植在原發(fā)性翼狀胬肉術(shù)后復(fù)發(fā)方面,差異有統(tǒng)計(jì)學(xué)意義〔RR=0.45,95%CI(0.35,0.58),P0.01〕。在復(fù)發(fā)性翼狀胬肉術(shù)后復(fù)發(fā)方面,差異有統(tǒng)計(jì)學(xué)意義〔RR=0.36,95%CI(0.27,0.49),P0.01〕。在術(shù)后并發(fā)癥方面,原發(fā)性翼狀胬肉角膜緣干細(xì)胞治療組總體的并發(fā)癥發(fā)生率為10.3%(18/174只眼),羊膜移植組總體的并發(fā)癥發(fā)生率為11.8%(19/161只眼),兩組間并發(fā)癥的發(fā)生率差異無統(tǒng)計(jì)學(xué)意義(Z=0.40,P=0.69)。復(fù)發(fā)性翼狀胬肉角膜緣干細(xì)胞移植組總體的并發(fā)癥發(fā)生率為11.8%(8/68只眼),羊膜移植組總體的并發(fā)癥發(fā)生率為10.6%(7/66只眼),兩組間并發(fā)癥的發(fā)生率差異無統(tǒng)計(jì)學(xué)意義(Z=0.20,P=0.84)。結(jié)論翼狀胬肉切除聯(lián)合自體角膜緣干細(xì)胞移植在原發(fā)性或復(fù)發(fā)性翼狀胬肉的術(shù)后效果優(yōu)于胬肉切除聯(lián)合羊膜移植,可減少?gòu)?fù)發(fā)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，
本文編號(hào)：2476799
[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，
本文編號(hào)：2476799
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