中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2011年
8期
812-815
,共4页
方秋云%沙翔垠%郑瑜%杨瑞明%曾敏智
方鞦雲%沙翔垠%鄭瑜%楊瑞明%曾敏智
방추운%사상은%정유%양서명%증민지
青光眼%小梁切除%浅前房%降压效果
青光眼%小樑切除%淺前房%降壓效果
청광안%소량절제%천전방%강압효과
Glaucoma%Trabeculectomy%Adjustable sutures
目的 探索取得更低眼压水平的安全的青光眼复合小梁切除手术方法.方法 观察接受复合小梁切除手术的65岁以下的原发慢性闭角型青光眼和原发开角型青光眼病人81例(98只眼),随机分为两组,即改良组和标准组.改良组25例患者(31只眼),巩膜瓣为5 mm×3 mm×5 mm长方形,约1/4～1/3厚,缝3针可调节缝线;标准组56例患者(67只眼),巩膜瓣5 mm×4 mm×4mm梯形,约1/2～1/3厚,缝2针可调节缝线,分析两组手术后浅前房发生率和3月时眼压情况.结果 浅前房情况:改良组31只眼,5例5只眼发生浅前房,其发生率为16.1%;标准组67只眼,5例5只眼发生浅前房,其发生率为7.5%.经x2检验分析,两组浅前房发生率的差别无统计学显著性意义(x 2=1.74,P＞0.1).手术后3个月眼压:改良组为8.1～16.5 mm Hg,平均为(12.5±1.9)mm Hg,而标准组为8.9～24.8 mm Hg,平均为(16.4±3.6)mm Hg,经t检验,两组均值的差异有统计学意义(t=2.36,P＜0.05).结论 与普遍采用的标准复合小梁切除手术相比,改良的复合小良切除手术后获得更低的眼压水平,同时浅前房发生率低.
目的 探索取得更低眼壓水平的安全的青光眼複閤小樑切除手術方法.方法 觀察接受複閤小樑切除手術的65歲以下的原髮慢性閉角型青光眼和原髮開角型青光眼病人81例(98隻眼),隨機分為兩組,即改良組和標準組.改良組25例患者(31隻眼),鞏膜瓣為5 mm×3 mm×5 mm長方形,約1/4～1/3厚,縫3針可調節縫線;標準組56例患者(67隻眼),鞏膜瓣5 mm×4 mm×4mm梯形,約1/2～1/3厚,縫2針可調節縫線,分析兩組手術後淺前房髮生率和3月時眼壓情況.結果 淺前房情況:改良組31隻眼,5例5隻眼髮生淺前房,其髮生率為16.1%;標準組67隻眼,5例5隻眼髮生淺前房,其髮生率為7.5%.經x2檢驗分析,兩組淺前房髮生率的差彆無統計學顯著性意義(x 2=1.74,P＞0.1).手術後3箇月眼壓:改良組為8.1～16.5 mm Hg,平均為(12.5±1.9)mm Hg,而標準組為8.9～24.8 mm Hg,平均為(16.4±3.6)mm Hg,經t檢驗,兩組均值的差異有統計學意義(t=2.36,P＜0.05).結論 與普遍採用的標準複閤小樑切除手術相比,改良的複閤小良切除手術後穫得更低的眼壓水平,同時淺前房髮生率低.
목적 탐색취득경저안압수평적안전적청광안복합소량절제수술방법.방법 관찰접수복합소량절제수술적65세이하적원발만성폐각형청광안화원발개각형청광안병인81례(98지안),수궤분위량조,즉개량조화표준조.개량조25례환자(31지안),공막판위5 mm×3 mm×5 mm장방형,약1/4～1/3후,봉3침가조절봉선;표준조56례환자(67지안),공막판5 mm×4 mm×4mm제형,약1/2～1/3후,봉2침가조절봉선,분석량조수술후천전방발생솔화3월시안압정황.결과 천전방정황:개량조31지안,5례5지안발생천전방,기발생솔위16.1%;표준조67지안,5례5지안발생천전방,기발생솔위7.5%.경x2검험분석,량조천전방발생솔적차별무통계학현저성의의(x 2=1.74,P＞0.1).수술후3개월안압:개량조위8.1～16.5 mm Hg,평균위(12.5±1.9)mm Hg,이표준조위8.9～24.8 mm Hg,평균위(16.4±3.6)mm Hg,경t검험,량조균치적차이유통계학의의(t=2.36,P＜0.05).결론 여보편채용적표준복합소량절제수술상비,개량적복합소량절제수술후획득경저적안압수평,동시천전방발생솔저.
Objective To explore save complex trabeculectomy to achieve lower intraocular pressure in glaucoma. Methods Eighty-one patients (98 eyes) with primary cbronic glaucoma received complex trabeculectomy in our hospital and were reviewed. All of the patients were divided into two groups according to the number of adjustable sutures of the operated eyes. The two groups were the modified and the standard. There were 25 cases (31 eyes) in modified group. All of the eyes had received complex trabeculectomy with 3 adjustable sutures and a scleral flap of 5×3×5mm and 1/4～1/3 sclera thick. There were 56 cases (67 eyes) in standard group. All of the eyes' had received complex trabeculectomy with 2 adjustable sutures and a scleral flap of 5×4×4 mm and 1/2～1/3 sclera thick The incidence rates of shallow anterior chamber and the intraocular pressures 3 months after operation were analyzed retrospectively. Results Shallow anterior chamber: There were 5 cases (5 eyes)occurrence in modified group (3leyes) with incidence rate of 16.1%. Among them 3 were the grade I and 2 were grade II. There were 5 cases (5 eyes) occurrence in standard group (67 eyes) with incidence rate of 7.5%. Among them 2 were the grade 1, 2 were grade Ⅱ and Ⅰ was grade Ⅲ. An alyzed by chi square test, the difference of.the incidence rates of the two groups was no signiificant statisticaUy (X2=1.74, P＞0.1). Intraocular pressures 3 months post-operation: The range of the pressure was 8.1 to 16.5 mmHg with the average of 12.5± 1.9 mmHg in modified group. The other range of the pressure was 8.9 to 24.8 mmHg with the average of 16.4± 3.6 mmHg in standard group. Analyzed by t test, the difference of the averages of the two groups was statistically significant (t=2.36, P ＜0.05). Conclusions Compared with the standard complex trabeculectomy which is common used by eye doctors at present the modified complex trabeculectomy is more effective for glaucoma to get the intraocular pressure at lower level after operation and the incidence of shallow anterior chamber is low.
