摘要
目的探讨生物羊膜与丝裂霉素C联合可调节缝线应用于小梁切除术的临床疗效。方法采用随机对照方法,将46例(52眼)青光眼患者分为生物羊膜与丝裂霉素C联合可调节缝线组26眼和常规小梁切除术组26眼。前者术中一次性应用丝裂霉素C,浓度为0.2 mg/mL,时间4 min,施行小梁切除术,并在巩膜瓣下进行生物羊膜移植术,联合角膜出针的可调节缝线;后者施行常规的小梁切除术。结果在生物羊膜与丝裂霉素C联合可调节缝线组中,术后3～5 d,26眼均未发生浅前房或前房消失;术后6个月,25眼均为Ⅰ、Ⅱ型滤过泡,1眼为Ⅲ型滤过泡;24眼的眼压均控制在正常范围内(≤21 mm Hg),2眼需用药物控制在正常范围内。在常规小梁切除组中,术后3～5 d,21眼前房形成好,5眼发生浅前房;术后6个月,20眼为Ⅰ、Ⅱ型滤过泡,6眼为Ⅲ、Ⅳ型滤过泡;20眼的眼压小于或等于21 mm Hg,6眼的眼压大于21 mm Hg。两组在眼压及前房、滤过泡形成情况等方面比较,差异有统计学意义(P<0.05)。结论生物羊膜与丝裂霉素C联合可调节缝线应用于小梁切除术可有效地防止术后早期发生浅前房或前房不形成,增强滤过道抗瘢痕化,有利于功能性滤过泡形成和眼压得到理想控制,从而提高手术的成功率。
Objective To explore the clinical efficiency of biological amnion and mitomycin C combined with the adjustable suture used in the trabeculectomy.Methods The 46 glaucoma patients（52 eyes）were randomly divided into biological amnion and mitomycin C combined with the adjustable suture group with 26 eyes,and conventional trabeculectomy group with 26 eyes.In former group,the mitomycin C with the concentration of 0.2 mg/mL was only one time used in operation for 4 minutes,then the trabeculectomy was done and under scleral flap,the biological amnion was implanted,combining with adjustable suture out of cornea.In control group,only conventional trabeculectomy was done.Results In biological amnion and mitomycin C combined with adjustable suture group,3-5 days after operation,none of 26 eyes had phenomenon of shallow anterior chamber or anterior chamber disappearing,and 6 months after operation,there were 25 eyes all belong to Ⅰ,Ⅱ type filtering bleb and 1 eye belong to Ⅲ type filtering bleb,and there were intraocular pressure（IOP） of 24 eyes all controlled within normal limit（IOP≤21 mm Hg）and 2 eyes needing medicine to control their IOP within normal limit.In conventional trabeculectomy group,3-5 days after operation,there were 21 eyes with well-forming anterior chamber,and 5 eyes with shallow anterior chamber phenomenon.6 months after operation,there were 20 eyes with Ⅰ type,Ⅱ type filtering bleb and 6 eyes with Ⅲ,Ⅳtype filtering bleb,and there were 20 eyes with IOP≤21 mm Hg and 6 eyes with IOP 21 mm Hg.The difference between the two groups was significant（P0.05）.Conclusion Biological amnion and mitomycin C combined with adjustable suture used in trabeculectomy can effectively prevent shallow anterior chamber or anterior chamber not forming in early stage after operation,enhance filter tract fighting against scar forming,which is beneficial to forming functional filtering bleb and controlling IOP into ideal state,and finally increase successful operation rate.
出处
《重庆医学》
CAS
CSCD
北大核心
2011年第6期550-551,554,共3页
Chongqing medicine
基金
重庆市医学科技计划资助项目(20082318)
