中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2011年
3期
243-246
,共4页
赵春梅%喻昌利%姜皓%谢九冰%刘彰
趙春梅%喻昌利%薑皓%謝九冰%劉彰
조춘매%유창리%강호%사구빙%류창
小梁切除术%结膜瓣%泪膜%干眼
小樑切除術%結膜瓣%淚膜%榦眼
소량절제술%결막판%루막%간안
Trabeculectomy%Conjunctiva flap%Tear film%Dry eye
目的 探讨不同结膜瓣小梁切除术术后泪膜稳定性的变化.方法 随机抽取2005年7月至2006年1月我院行小梁切除术的青光眼患者93例112只眼,分两组.A组:以穹窿为基底结膜瓣组42例56只眼;B组:以角膜缘为基底结膜瓣组51例56只眼.平均年龄(62.3±10.5)岁.询问患者异物感、干涩灼热感和畏光感情况,检查结膜充血及分泌物情况,检测术前1d,术后1、7、14、30d的泪膜破裂时间(breakuptime,BUT)、基础泪液分泌试验(Schirmer I test,SIT)、角膜荧光素染色积分(fluorescence integral,F I).结果 两组间异物感术后14d及30d比较差异有统计学意义(P＜0.05,P＜0.01).两组间干涩灼热感术后7d、14d及30d比较差异有统计学意义(P＜0.05,P＜0.01,P＜0.01).两组间畏光感术后7d、14d及30d比较差异有统计学意义(P＜0.05,P＜0.05,P＜0.01).两组间结膜充血术后7d、14d及30d比较差异有统计学意义(P＜0.05,P＜0.05,P＜0.01).两组间分泌物术后14d及30d比较差异有统计学意义(均P＜0.05).两组间Schirmer I试验术后1d、7d、14d及30d比较、差异均有统计学意义(P＜0.05,P＜0.01,P＜0.01,P＜0.01),A组数值较B组明显减少.两组间BUT术后1d、7d、14d及30d比较差异均有统计学意义(P＜0.01,P＜0.01,P＜0.01,P＜0.05).两组间角膜荧光素染色术后1d、7d、14d及30d比较差异均有统计学意义(P＜0.01,P＜0.05,P＜0.01,P＜0.01).结论 以穹窿为基底结膜瓣的小梁切除术显著降低泪膜的稳定性,而以角膜缘为基底结膜瓣的小梁切除术对泪膜影响较小.
目的 探討不同結膜瓣小樑切除術術後淚膜穩定性的變化.方法 隨機抽取2005年7月至2006年1月我院行小樑切除術的青光眼患者93例112隻眼,分兩組.A組:以穹窿為基底結膜瓣組42例56隻眼;B組:以角膜緣為基底結膜瓣組51例56隻眼.平均年齡(62.3±10.5)歲.詢問患者異物感、榦澀灼熱感和畏光感情況,檢查結膜充血及分泌物情況,檢測術前1d,術後1、7、14、30d的淚膜破裂時間(breakuptime,BUT)、基礎淚液分泌試驗(Schirmer I test,SIT)、角膜熒光素染色積分(fluorescence integral,F I).結果 兩組間異物感術後14d及30d比較差異有統計學意義(P＜0.05,P＜0.01).兩組間榦澀灼熱感術後7d、14d及30d比較差異有統計學意義(P＜0.05,P＜0.01,P＜0.01).兩組間畏光感術後7d、14d及30d比較差異有統計學意義(P＜0.05,P＜0.05,P＜0.01).兩組間結膜充血術後7d、14d及30d比較差異有統計學意義(P＜0.05,P＜0.05,P＜0.01).兩組間分泌物術後14d及30d比較差異有統計學意義(均P＜0.05).兩組間Schirmer I試驗術後1d、7d、14d及30d比較、差異均有統計學意義(P＜0.05,P＜0.01,P＜0.01,P＜0.01),A組數值較B組明顯減少.兩組間BUT術後1d、7d、14d及30d比較差異均有統計學意義(P＜0.01,P＜0.01,P＜0.01,P＜0.05).兩組間角膜熒光素染色術後1d、7d、14d及30d比較差異均有統計學意義(P＜0.01,P＜0.05,P＜0.01,P＜0.01).結論 以穹窿為基底結膜瓣的小樑切除術顯著降低淚膜的穩定性,而以角膜緣為基底結膜瓣的小樑切除術對淚膜影響較小.
목적 탐토불동결막판소량절제술술후루막은정성적변화.방법 수궤추취2005년7월지2006년1월아원행소량절제술적청광안환자93례112지안,분량조.A조:이궁륭위기저결막판조42례56지안;B조:이각막연위기저결막판조51례56지안.평균년령(62.3±10.5)세.순문환자이물감、간삽작열감화외광감정황,검사결막충혈급분비물정황,검측술전1d,술후1、7、14、30d적루막파렬시간(breakuptime,BUT)、기출루액분비시험(Schirmer I test,SIT)、각막형광소염색적분(fluorescence integral,F I).결과 량조간이물감술후14d급30d비교차이유통계학의의(P＜0.05,P＜0.01).량조간간삽작열감술후7d、14d급30d비교차이유통계학의의(P＜0.05,P＜0.01,P＜0.01).량조간외광감술후7d、14d급30d비교차이유통계학의의(P＜0.05,P＜0.05,P＜0.01).량조간결막충혈술후7d、14d급30d비교차이유통계학의의(P＜0.05,P＜0.05,P＜0.01).량조간분비물술후14d급30d비교차이유통계학의의(균P＜0.05).량조간Schirmer I시험술후1d、7d、14d급30d비교、차이균유통계학의의(P＜0.05,P＜0.01,P＜0.01,P＜0.01),A조수치교B조명현감소.량조간BUT술후1d、7d、14d급30d비교차이균유통계학의의(P＜0.01,P＜0.01,P＜0.01,P＜0.05).량조간각막형광소염색술후1d、7d、14d급30d비교차이균유통계학의의(P＜0.01,P＜0.05,P＜0.01,P＜0.01).결론 이궁륭위기저결막판적소량절제술현저강저루막적은정성,이이각막연위기저결막판적소량절제술대루막영향교소.
Objective To study the effective of two kinds of conjunctiva flap on tear film after trabeculectomy.Methods Ninety-three cases (112 eyes) of glaucoma patients who received trabeculectomy from Jul.2005 to Jan.2006 were randomly divided into 2 groups.Group A (56 eyes):fornix based conjunctival flaps;group B (56 eyes):limbus based conjunctival flaps.The average age was 62.3± 10.5 years old.The symptoms and signs of dry eye disease,tear break-up time (BUT),Schirmer I test (SIT) value and corneal fluorescein staining were analyzed 1 day preoperatively and 1 day,7,14 and 30 days postoperatively.Results Compared with the two groups 14 and 30 days postoperatively,foreign body sensation of group A was more than that of group B (P＜0.05,P＜0.01).Compared with the two groups 7,14 and 30 days postoperatively,dryness of group A was more than that of group B (P ＜0.05,P＜0.01,P ＜0.01).Compared with the two groups 7,14 and 30 days postoperatively,photophobia of group A was more than that of group B (P ＜0.05,P ＜0.05,P＜0.01).Compared with the two groups 7,14 and 30 days postoperatively,conjunctival congestion of group A was more than that of group B (P ＜0.05,P＜0.05,P＜0.01).Compared with the two groups 14 and 30 days postoperatively,secretions of group A was more than that of group B (P＜0.05).Compared with the two groups 1day,7,14 and 30 days postoperatively,Schirmer I test (SIT) value of group A was less than that of group B (P＜0.05,P＜0.01,P＜0.01,P＜0.01).Compared with the two groups 1 day,7,14 and 30 days postoperatively,tear break-up time(BUT) of group A was less than that of group B (P ＜0.01,P ＜0.01,P ＜0.01,P ＜0.05).Compared with the two groups 1 day,7,14 and 30 days postoperatively,corneal fluorescein staining of group A was more than that of group B (P ＜0.01,P ＜0.05,P ＜0.01,P ＜0.01).Conclusions The stability of the tear film in trabeculectomy of the fomix basal conjunctival flap are more significantly reduced than of the limbus basal conjunctival flap.
