【摘要】 目的 评价贝伐单抗作为翼状胬肉手术辅助治疗药物的安全性及有效性。方法 前瞻性随机临床试验研究。95只单侧鼻侧翼状胬肉眼，均行胬肉切除联合角膜缘干细胞移植术，按随机数字表法分为3组，其中A组32眼，单纯手术治疗，未行球结膜下注药；B组34眼，采用在术中加用贝伐单抗（2.5 mg/0.1 ml）球结膜下注射1次；C组29眼，采用在术中及术后2周各加用贝伐单抗（2.5 mg/0.1 ml）球结膜下注射1次。结果随访6个月，统计学方法采用单因素方差分析、卡方检验、Mann-Whitney及Kruskall-Wallis检验。结果 3组干细胞植片均存活良好，无角膜上皮缺失、糜烂、角膜变薄等并发症发生。仅A组有4例复发，差异有统计学意义（H=7.50，P<0.05）。单次与2次球结膜下注射临床疗效无明显差异。结论 贝伐单抗联合角膜缘干细胞移植可有效抑制翼状胬肉的复发，未见明显并发症，且2次注射结果并未优于单次注射。
【关键词】 翼状胬肉； 贝伐单抗； 角膜缘干细胞移植； 结膜下注射
DOI：10.3760/cma.j.issn.1674-845X.2014.12.012
作者单位：325015 温州眼科（Email：zhangyanggirl@163.com）
The application and effect of Bevacizumabin pterygium surgery
Zhang Yang.Department of Ophthalmology， the First Affiliated Hospital of Wenzhou Medical University， Wenzhou 325015， China
【Abstract】 Objective To evaluate the safetyand efficacy of bevacizumab application as an adjuvant therapy for pterygiumexcision surgery. Methods In thisprospective clinical trial， 95 eyes with unilateral nasal pterygium underwent pterygiumexcision surgery combined with limbal stem cell autografting， and were assigned into 3 groups atrandom： group A （32 eyes） did not receive a bevacizumabinjection； group B （34 eyes） received a single dose ofsubconjunctival bevacizumab injection （2.5 mg/0.1 ml） intraoperatively； group C （29 eyes） received subconjunctival bevacizumab injection （2.5 mg/0.1 ml）， one dose intraoperatively andanother 2 weeks postoperatively. Patients were followed for 6 months. A one-wayanalysis of variance， chi-square test， Mann-Whitney and Kruskall-Wallis tests were used for statisticalanalysis. Results At the end of thestudy， all stemcell autografts in 3 groups remained alive， with no complications of missing corneal epithelium， erosion or corneal thinningoccurring. Pterygium recurrences were only observed in 4 cases in group A， and the occurrence wasstatistically significant （H=7.50， P<0.05）. No significant difference wasfound in the clinical efficacy between patients receiving single or doubledoses of subconjunctival injection. Conclusion Bevacizumab injection combined with limbal stem cell autografting inpterygium excision surgery can effectively inhibit the recurrence of pterygiumwith no apparent complications. Multiple injections do not yield a betterclinical outcome compared to a single dose.
【Key words】 Pterygium； Bevacizumab； Conjunctival allograft； Subconjunctival injection
