国际眼科杂志
國際眼科雜誌
국제안과잡지
INTERNATIONAL JOURNAL OF OPHTHALMOLOGY
2011年
6期
943-946
,共4页
人脐带静脉管%非穿透性小梁手术%眼压
人臍帶靜脈管%非穿透性小樑手術%眼壓
인제대정맥관%비천투성소량수술%안압
human umbilical vein%non-penetrating trabecular surgery%IOP
目的:研究人脐带静脉管(HUV)植入联合应用丝裂霉素C(MMC)在非穿透性小梁手术(NPTS)中应用的临床效果.方法:选取中、晚期原发性开角型青光眼病例32例(46眼).患者分为两组:HUV+MMC组(n=25),透明质酸生物胶(SKGEL)+MMC组(n=21);行非穿透性小梁手术,HUV+MMC组将HUV置于巩膜床内,SKGEL+MMC组将SKGEL缝合固定于巩膜床上.术后分别于1,2,4wk;2,6,12mo裂隙灯下观察术口愈合情况、滤过泡情况、前房炎症反应、前房深度、有无出血等.测量眼压、最佳矫正视力,计算手术成功率.结果:HUA+MMC组的术后眼压平均在16mmHg,HUA+MMC组与SKGEL+MMC组在术后1,2,4wk;2,6,12mo时P>0.05,差异无显著性;功能性滤过泡术后1wk～12mo时HUA+MMC组与SKGEL+MMC组比较无显著性差异(P>0.05),末次随访HUA+MMC组成功(完全成功和条件成功)21眼,成功率84%;SKGEL+MMC组成功18眼,成功率86%.两组末次随访手术成功率比较无显著性差异(P>0.05).结论:HUV联合MMC在NPFS中对术眼有明显而稳定的降压作用,大大提高了NPTS的手术成功率.脐带静脉管取材方便,抗原性低,有良好的组织相容性,眼局部反应轻,无毒副作用,且与SKGEL植入物相比,价格便宜,是理想的NPTS中的植入物.
目的:研究人臍帶靜脈管(HUV)植入聯閤應用絲裂黴素C(MMC)在非穿透性小樑手術(NPTS)中應用的臨床效果.方法:選取中、晚期原髮性開角型青光眼病例32例(46眼).患者分為兩組:HUV+MMC組(n=25),透明質痠生物膠(SKGEL)+MMC組(n=21);行非穿透性小樑手術,HUV+MMC組將HUV置于鞏膜床內,SKGEL+MMC組將SKGEL縫閤固定于鞏膜床上.術後分彆于1,2,4wk;2,6,12mo裂隙燈下觀察術口愈閤情況、濾過泡情況、前房炎癥反應、前房深度、有無齣血等.測量眼壓、最佳矯正視力,計算手術成功率.結果:HUA+MMC組的術後眼壓平均在16mmHg,HUA+MMC組與SKGEL+MMC組在術後1,2,4wk;2,6,12mo時P>0.05,差異無顯著性;功能性濾過泡術後1wk～12mo時HUA+MMC組與SKGEL+MMC組比較無顯著性差異(P>0.05),末次隨訪HUA+MMC組成功(完全成功和條件成功)21眼,成功率84%;SKGEL+MMC組成功18眼,成功率86%.兩組末次隨訪手術成功率比較無顯著性差異(P>0.05).結論:HUV聯閤MMC在NPFS中對術眼有明顯而穩定的降壓作用,大大提高瞭NPTS的手術成功率.臍帶靜脈管取材方便,抗原性低,有良好的組織相容性,眼跼部反應輕,無毒副作用,且與SKGEL植入物相比,價格便宜,是理想的NPTS中的植入物.
목적:연구인제대정맥관(HUV)식입연합응용사렬매소C(MMC)재비천투성소량수술(NPTS)중응용적림상효과.방법:선취중、만기원발성개각형청광안병례32례(46안).환자분위량조:HUV+MMC조(n=25),투명질산생물효(SKGEL)+MMC조(n=21);행비천투성소량수술,HUV+MMC조장HUV치우공막상내,SKGEL+MMC조장SKGEL봉합고정우공막상상.술후분별우1,2,4wk;2,6,12mo렬극등하관찰술구유합정황、려과포정황、전방염증반응、전방심도、유무출혈등.측량안압、최가교정시력,계산수술성공솔.결과:HUA+MMC조적술후안압평균재16mmHg,HUA+MMC조여SKGEL+MMC조재술후1,2,4wk;2,6,12mo시P>0.05,차이무현저성;공능성려과포술후1wk～12mo시HUA+MMC조여SKGEL+MMC조비교무현저성차이(P>0.05),말차수방HUA+MMC조성공(완전성공화조건성공)21안,성공솔84%;SKGEL+MMC조성공18안,성공솔86%.량조말차수방수술성공솔비교무현저성차이(P>0.05).결론:HUV연합MMC재NPFS중대술안유명현이은정적강압작용,대대제고료NPTS적수술성공솔.제대정맥관취재방편,항원성저,유량호적조직상용성,안국부반응경,무독부작용,차여SKGEL식입물상비,개격편의,시이상적NPTS중적식입물.
AIM: To investigate the clinical therapeutic effects of human umbilical vein (HUV)implantation and mitomycin C (MMC) in non-penetrating trabecular surgery (NPTS). METHODS:A total of 32 patients (46 eyes) with uncontrolled primary open angle glaucoma (POAG) were divided into two groups: HUV+MMC group (n=25), SKGEL+MMC group (n=21). The procedure commenced with the creation of a limbus based conjunctival flap. After the dissection of a superficial limbus based rectangular scleral flap, MMC(0.4mg/mL) was used superior and inferior surface of the superficial scleral flap for three minutes. A second limbus based scleral flap was carefully dissected beneath the previous one towards the choroid. Schlemm's canal was deroofed during the extension of the deep scleral flap toits limbal edges. HUV or SKGEL fixed on the bed of sclera in experimental group. Postoperative examinations were performed at 1 week,2,4 weeks;2,6,12 months. IOP,best-corrected visual acuity(BCVA), functional blebs and success rate were examined. RESULTS: There were no statistically differences with postoperative IOP in HUV+MMC group and SKGEL+MMC group (P>0.05) during 1 week to 12 months. There was no difference with postoperative function blebs and the change of BCVA during 1 week to 12 months between HUV+MMC group and SKGEL+MMC group (P>0.05).At 12 months after surgery, the success rate was 84% in HUV+MMC group,86% in SKGEL+MMC group. CONCLUSION: The application of HUV in NPTS can prevent the adhesion of filtering channel and it can improve the success rate of NPTS. Compared with SKGEL, HUV has lower price. So it is a better implant.
