摘要
目的通过对40例小梁切除术失败病例行针刺结膜下、巩膜瓣下分离，并结合结膜下注射干扰素（INFα-2b）治疗效果的回顾性分析，探讨抗青光眼滤过术滤过通道重建的意义和方法。方法40例患者采用随机对照临床试验方法平均分为两组，一组行外路分离，另一组行内路分离，观察治疗效果并进行统计学分析。结果内路分离组：治疗前平均眼压（28．01±4．54）mmHg，治疗后眼压平均（14．75±4．39）mmHg，统计学分析眼压治疗前后差异具有统计学意义（P〈0．01）。外路分离组：治疗前眼压平均为（27．16±4．39）mmHg，治疗后：小梁切除术后2个月内11例眼压平均（15．88±3．96）mmHg，治疗前后眼压差异有统计学意义（P〈0．01）；小梁切除术后3～5个月内有7例治疗失败，改行二次手术，不做统计分析。两组间治疗前无差异。治疗后：小梁切除术后2个月内稍有差异，3～5个月内有明显差异，有统计学意义（P〈0．05）。结论小梁切除术后2个月内，内、外路分离均取得较好效果，2个月以上外路分离效果差，内路分离效果好；结合结膜下注射干扰素有明显抑制瘢痕形成的作用。
Objective To evaluate the effectiveness of re-establishment of filtration tunnel against two glaucoma filtering operations, through a retrospective analysis of 40 trabeculectomy failure patients by acupunctural separation of conjunctiva and scleral flap in combination with subconjunctival injection of INFα- 2b. Methods Forty patients with glaucoma subjected to randomized clinical trial were divided equally into two groups treated with extra-path or inner-path commissurotomy, and the mean intraocular pressure （IOP） was measured before and after the operation for the evaluation of the effectiveness of acupunctural separation. Results The IOP [ （14.75 ±4.39） mm Hg] after the inner-path commissurotomy had a significant decrease statistically （ P 〈 0.01 ） compared with that [ （28.01 ± 4. 54） mm Hg ] before the operation. The IOP [ （ 27. 16 ±4. 39） mm Hg] after the extra-path commissurotomy also had a significant decrease statistically （P 〈0. 01 ） compared with that [ （ 15.88 ±3.96） mm Hg] before the operation based on 11 cases with trabeculectomy within 2 months, whiles the statistical outcome was absent due to the failure of separation operation in 7 cases with trabeculectomy within 3 ~ 5 months. Conclusions The effectiveness of inner-path commissurotomy was similar to that of extra-path commissurotomy after trabeculectomy within 2 months, while the effectiveness of inner-path commissurotomy was better than that of extra-path commissurotomy after trabeculectomy more than 2 months. The cicatrisation was inhibited after the subconjunctival injection of INFα-2b.
出处
《中华航海医学与高气压医学杂志》
CAS
CSCD
2007年第1期41-44,共4页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
关键词
针刺分离
内路分离
外路分离
干扰素
滤过重建
Acupunctural separation
Inner-path commissurotomy
Extra-path commissurotomy
INF
Filtration tunnel re-establishment
