复合式小梁切除术治疗青光眼患者的临床研究(1)

http://www.100md.com 2012年2月5日 黄信

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     [摘要] 目的 探讨复合式小梁切除术治疗青光眼的临床疗效。 方法 将我院57例(61眼)青光眼患者随机分为研究组(30眼)与对照组(31眼)，分别行复合式小梁切除术(联合丝裂霉素)及传统小梁切除术，比较两组视力、眼压及滤过泡，并随访3个月。 结果 术后3个月两组视力比较，差异无统计学意义(χ2=0.50，P > 0.05)，术后远期研究组眼压显著低于对照组(t = 5.614，P < 0.05)，术后3个月研究组滤过泡发生率显著低于对照组(P < 0.01)。 结论 复合式小梁切除术治疗青光眼疗效确切，值得在青光眼手术中推广。

    [关键词] 青光眼；复合式小梁切除术；丝裂霉素

    [中图分类号] R755 [文献标识码] A [文章编号] 1673-7210(2012)02(a)-0028-02

    Clinical research on complex trabeculectomy in the treatment of glaucoma

    HUANG Xin

    Department of Ophthalmology, the People's Hospital of Tiandeng County, Guangxi Zhuang Autonomous Region, Tiandeng 532800, China

    [Abstract] Objective To study the clinical effect of complex trabeculectomy in the treatment of glaucoma. Methods 57 cases (61 eyes) with glaucoma were divided into study group (30 eyes) and control group (31 eyes), study group was given complex trabeculectomy with Mitomycin, control group was given traditional trabeculectomy. The visual acuity, intraocular pressure and filter bulbs were measured and compared between the two groups during 3 months after operation. Results Visual acuity was no significant difference between the two groups after 3 months (χ2=0.50, P > 0.05). The intraocular pressure of long-term postoperative of study group was significantly lower than that of control group (t = 5.614，P < 0.05). The incidence of filter bulbs of study group was significantly lower than that of control group (P < 0.01). Conclusion The complex trabeculectomy is effective for glaucoma, and it is worthy of application in glaucoma surgical operation.

    [Key words] Glaucoma; Complex trabeculectomy; Mitomycin

    青光眼在临床上亦称为不可逆性致盲眼病，近年来发病率有快速上升趋势。临床常用的治疗方法有药物治疗、激光疗法及外科手术治疗。近年来，多以外科手术为主要的手术治疗方法。手术治疗青光眼主要以小梁切除为主。近年来临床研究提示，复合式小梁切除术具有恢复速度快，术后浅前房控制效果好等优势[1]，而广泛应用于青光眼的手术治疗。本研究采用复合式小梁切除术治疗青光眼，术后患者视力、眼压等改善效果好，现报道如下：

    1 资料与方法

    1.1 一般资料

    选择2009年12月~2011年3月在我院确诊的青光眼患者57例(61眼)，其中，男36例(38眼)，女21例(23眼)；年龄41~63岁，平均54岁；青光眼类型：原发闭角型青光眼32眼，原发性开角型青光眼29眼。术前视力0.3~1.0，术前眼压(28.54±3.22)mm Hg(1 mm Hg = 0.133 kPa)。将所有患者随机分为研究组(30眼)及对照组(31眼)，随访3个月。

    1.2 方法

    采用2%利多卡因与0.75%布比卡因对所有研究对象进行球周麻痹。手术过程均为显微镜下操作。

    1.2.1 研究组 采用复合式小梁切除术 ......

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