海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2014年
17期
2534-2536
,共3页
丝裂霉素C%小梁切除术%薄壁滤过泡
絲裂黴素C%小樑切除術%薄壁濾過泡
사렬매소C%소량절제술%박벽려과포
Mitomycin C%Trabeculectomy%Thin-walled filtering bleb
目的：探讨小梁切除术后早期选择性一次或多次结膜下注射低浓度丝裂霉素C（Mitomycin C， MMC）对滤过泡形态及眼压的影响。方法收集2011年1月至2012年3月就诊于我院的60例原发性急性闭角型青光眼且需行小梁切除术的患者，随机分为A、B两组各30例，A组术后根据滤过泡形态、结膜充血状态一次或多次结膜下注射低浓度MMC (0.2 mg/ml)，B组术中一次性使用MMC (0.33 mg/ml)，随访1年，记录并比较两组患者滤过泡形态及眼压的差异。结果术后1年A组扁平弥散型滤过泡占总数的66.7%，B组扁平弥散型滤过泡占总数的36.7%，两组比较差异有统计学意义(P=0.038)。术后1年时A组眼压控制良好者占76%，B组眼压控制良好者占80%，两组比较差异无统计学意义(P=1.000)。A组出现2眼角膜上皮缺损，1例局部注射部位结膜苍白；B组出现1例角膜上皮缺损，5眼滤过泡渗漏，2眼低眼压黄斑病变。结论小梁切除术后选择性结膜下注射较低浓度的MMC使得扁平弥散型滤过泡的比率增加，与术中一次性使用MMC相比两组均能较好控制眼压，手术成功率相似，此种治疗方式安全有效，且无严重并发症发生。
目的：探討小樑切除術後早期選擇性一次或多次結膜下註射低濃度絲裂黴素C（Mitomycin C， MMC）對濾過泡形態及眼壓的影響。方法收集2011年1月至2012年3月就診于我院的60例原髮性急性閉角型青光眼且需行小樑切除術的患者，隨機分為A、B兩組各30例，A組術後根據濾過泡形態、結膜充血狀態一次或多次結膜下註射低濃度MMC (0.2 mg/ml)，B組術中一次性使用MMC (0.33 mg/ml)，隨訪1年，記錄併比較兩組患者濾過泡形態及眼壓的差異。結果術後1年A組扁平瀰散型濾過泡佔總數的66.7%，B組扁平瀰散型濾過泡佔總數的36.7%，兩組比較差異有統計學意義(P=0.038)。術後1年時A組眼壓控製良好者佔76%，B組眼壓控製良好者佔80%，兩組比較差異無統計學意義(P=1.000)。A組齣現2眼角膜上皮缺損，1例跼部註射部位結膜蒼白；B組齣現1例角膜上皮缺損，5眼濾過泡滲漏，2眼低眼壓黃斑病變。結論小樑切除術後選擇性結膜下註射較低濃度的MMC使得扁平瀰散型濾過泡的比率增加，與術中一次性使用MMC相比兩組均能較好控製眼壓，手術成功率相似，此種治療方式安全有效，且無嚴重併髮癥髮生。
목적：탐토소량절제술후조기선택성일차혹다차결막하주사저농도사렬매소C（Mitomycin C， MMC）대려과포형태급안압적영향。방법수집2011년1월지2012년3월취진우아원적60례원발성급성폐각형청광안차수행소량절제술적환자，수궤분위A、B량조각30례，A조술후근거려과포형태、결막충혈상태일차혹다차결막하주사저농도MMC (0.2 mg/ml)，B조술중일차성사용MMC (0.33 mg/ml)，수방1년，기록병비교량조환자려과포형태급안압적차이。결과술후1년A조편평미산형려과포점총수적66.7%，B조편평미산형려과포점총수적36.7%，량조비교차이유통계학의의(P=0.038)。술후1년시A조안압공제량호자점76%，B조안압공제량호자점80%，량조비교차이무통계학의의(P=1.000)。A조출현2안각막상피결손，1례국부주사부위결막창백；B조출현1례각막상피결손，5안려과포삼루，2안저안압황반병변。결론소량절제술후선택성결막하주사교저농도적MMC사득편평미산형려과포적비솔증가，여술중일차성사용MMC상비량조균능교호공제안압，수술성공솔상사，차충치료방식안전유효，차무엄중병발증발생。
Objective To explore the influence of one or more times selective subconjunctival injections of low-concentration mitomycin C (MMC) at early stage on the morphology of filtering bleb and IOP after trabeculecto-my. Methods Sixty patients with primary acute angle-closure glaucoma who needed trabeculectomy in our hospital from January 2011 to March 2012 were divided into two groups randomly (n=30). In group A, according to the mor-phology of filtering bleb and the state of conjunctival congestion, low-concentration of MMC (0.2 mg/ml) was subcon-junctival injected once or more times. In group B, MMC (0.33 mg/ml) was used once during operation. The filtering bleb and IOP in two groups were recorded and followed up for one year, and then compared. Results 1 year after the operation, the ratio of typeⅡfiltering bleb in group A was 66.7%, while that in group B was 36.7%(P=0.038). The ra-tio of well-controlled IOP was 76%in group A and that in group B was 80%(P=1.000). In group A, there were 2 cases of persistent corneal epithelial defect and 1 case of partial pale conjunctiva at the site of injection. In group B, there were 1 case of persistent corneal epithelial defect, 5 cases of filtering bleb leaking and 2 cases of ocular hypotensional macu-lopathy. Conclusion Selective subconjunctive injection of low-concentration MMC after trabeculectomy could im-prove the ratio of flat and diffuse filtering bleb. The IOPs in both groups are well controlled and the rates of successful operation are similar. This treatment is effective and safe, with no severe complications observed.
