翼状胬肉切除术后并发角膜溃疡的危险因素分析

Analysis of risk factors for corneal ulcer after pterygium excision

摘要:

目的 探讨翼状胬肉切除术后并发角膜溃疡的危险因素。方法 选取2017年5月—2022年3月在青岛市中医医院行翼状胬肉切除术的患者153例，统计术后角膜溃疡发生情况，将并发角膜溃疡的患者作为发生组，其余作为未发生组。比较两组患者一般资料，采用多因素Logistic逐步回归模型分析翼状胬肉切除术后并发角膜溃疡的危险因素。结果 153例行翼状胬肉切除术的患者，术后30例并发角膜溃疡作为发生组，其余123例作为未发生组。与未发生组比较，发生组糖尿病、复发性翼状胬肉、手术操作不规范、角膜缝线松动及激素类药物应用不合理的构成比升高（P <0.05）。多因素Logistic逐步回归分析结果显示，糖尿病［O^R=2.678（95% CI：2.013，3.343）］、复发性胬肉［O^R=2.280（95% CI：1.659，2.900）］、手术操作不规范［O^R=7.036（95% CI：4.152，9.919）］、角膜缝线松动［O^R=3.466（95% CI：2.632，4.300）］及激素类药物应用不合理［O^R=5.217（95% CI：3.021，7.414）］均是翼状胬肉切除术后并发角膜溃疡的危险因素（P <0.05）。结论 糖尿病、复发性胬肉、手术操作不规范、角膜缝线松动及激素类药物应用不合理均是翼状胬肉切除术后并发角膜溃疡的危险因素，临床可据此采取针对性干预措施，以减少术后角膜溃疡的发生。

Abstract:

Objective To analyze the risk factors for corneal ulcer after pterygium excision.Methods A total of 153 patients who underwent pterygium excision in our hospital from May 2017 to March 2022 were selected and the incidence of postoperative corneal ulcer was analyzed. The patients with corneal ulcers were set as the occurrence group and the others as the non-occurrence group. The general data of the two group were compared, and the risk factors for corneal ulcer after pterygium excision were analyzed by multivariable Logistic regression models.Results Among 153 patients undergoing pterygium excision, 30 patients with postoperative corneal ulcer were included as the occurrence group, and the other 123 patients were included as the non-occurrence group. Compared with the non-occurrence group, the proportions of diabetes mellitus, recurrent pterygium, non-standard surgical technique, loose corneal suture and irrational application of steroids in the occurrence group were higher (P < 0.05). Multivariable Logistic regression analysis demonstrated that diabetes mellitus [O^R = 2.678 (95% CI: 2.013, 3.343) ], recurrent pterygium [O^R = 2.280 (95% CI: 1.659, 2.900) ], non-standard surgical technique [O^R = 7.036 (95% CI: 4.152, 9.919) ], loose corneal suture [O^R = 3.466 (95% CI: 2.632, 4.300) ] and irrational application of steroids [O^R = 5.217 (95% CI: 3.021, 7.414) ] were all risk factors for corneal ulcer after pterygium excision (P < 0.05).Conclusions Diabetes mellitus, recurrent pterygium, non-standard surgical technique, loose corneal suture and irrational application of steroids are all risk factors for corneal ulcer after pterygium excision. Therefore, targeted measures can be taken to reduce the incidence of postoperative corneal ulcer in clinical practice.