摘要
目的探讨丝裂霉素C联合巩膜瓣可移动缝线治疗原发性青光眼的临床效果。方法按照手术方式不同将本院收治的120例原发性青光眼患者分为常规组40例、丝裂霉素C组40例和缝线组40例,常规组给予常规小梁切除术治疗,丝裂霉素C组术中应用丝裂霉素C的小梁切除术治疗,缝线组术中联合使用丝裂霉素C+巩膜瓣可移动缝线小梁切除术治疗,比较3组患者术前、术后第3天、术后1周、术后1个月、术后3个月和术后6个月的眼压变化,术后半年滤过泡情况、术后早期前房深度以及并发症发生情况。结果 3组患者术后眼压均显著下降,与术前比较,差异有统计学意义(P<0.05);丝裂霉素C组和缝线组患者术后不同时间眼压均显著低于常规组,差异有统计学意义(P<0.05);丝裂霉素C组和缝线组患者功能性滤泡形成率均显著高于常规组,差异有统计学意义(P<0.05);丝裂霉素C组患者术后早期Ⅰ、Ⅱ度浅前房发生率均显著高于常规组,差异有统计学意义(P<0.05);缝线组患者术后早期Ⅰ、Ⅱ度浅前房发生率均显著低于丝裂霉素C组,差异有统计学意义(P<0.05);3组均未出现角膜损伤、结膜瓣漏、黄斑水肿、眼内炎、恶性青光眼等并发症。丝裂霉素C组患者正常前房率显著低于常规组和缝线组,差异有统计学意义(P<0.05)。结论原发性青光眼术中丝裂霉素C联合巩膜瓣可移动缝线能显著提高手术的成功率,改善眼压,合理控制缝线的拆除数目及时间,临床应用和推广价值较高。
Objective To explore the clinical effect of mitomycin-C combining with sclera flap movable suture in the operation of primary glaucoma. Methods According to different surgical methods,120 patients with primary glaucoma were evenly divided into regular group,mitomycin-C group and suture group.Conventional trabeculectomy was provided in the regular group.Mitomycin-C trabeculectomy was adopted in the mitomycin-C group.Trabeculectomy of mito-mycin-C with sclera flap movable suture was applied in the suture group.Changes of intraocular pressure before surgery,3 days,one week,one month,3 months,and 6 months after surgery,filtering bleb after half a year,postoperative chamber depth at an early stage,and complications were compared among 3 groups. Results IOP all greatly decreased after surgeries among 3 groups in comparison with that before surgery with statistical differences （P〈0.05）.In the mitomycin-C group and suture group,IOP in different periods was lower than that in the regular group with statistical differences （P〈0.05）.Formation rates of functional filtering blebs in the mitomycin-C group and suture group were both higher than that in the regular group with statistical differences （P〈0.05）.Incidences of postoperative shallow anterior chamberⅠ degree and Ⅱ degree at early periods in the mitomycin-C group were both obviously higher than that in the regular group with statistical differences （P〈0.05）.Incidences of postoperative shallow anterior chamber Ⅰ degree andⅡ degree at early periods in the suture group were both lower than that in the mitomycin-C group,which displayed sta-tistical significances （P〈0.05）. Conclusion In the operation of primary glaucoma,combination of mitomycin-C and sclera flap movable suture can greatly increase operation success rate,improve IOP,and reasonably control the number and time of removed stitches,which has a higher value of clinical application and expansion.
出处
《中国当代医药》
2014年第23期11-13,16,共4页
China Modern Medicine
基金
江西省新余市科技计划项目(余财教[2012]59号)
