壳聚糖膜缓释给药系统在小梁切除术中的应用  

Application of chitosan film atrigel in trabeculectomy

作　　者：金中秋[1] 商旭敏[2] 周和政[1] 周雄[1] 张文强[1] 陈华新[1] 王百川[1] 阎玉华[3] 高玉香[3] 

机构地区：[1]广州军区武汉总医院眼科,湖北省武汉市430070 [2]第一军医大学研究生队,广东省广州市510515 [3]武汉理工大学生物中心,湖北省武汉市430070

出　　处：《眼科新进展》2007年第1期30-33,共4页Recent Advances in Ophthalmology

摘　　要：目的观察壳聚糖膜缓释给药系统在小梁切除术中应用的组织反应以及降眼压效果。方法24只48眼新西兰大白兔随机分成A、B、C3组,A组单纯行小梁切除术,作为手术对照;B组行小梁切除术联合壳聚糖膜巩膜瓣下植入;C组行小梁切除术联合曲安奈德壳聚糖膜缓释给药系统巩膜瓣下植入。术后观察眼压、炎症反应、结膜滤泡等,并分别于7d、14d、28d、56d取标本行组织学检查。结果术前各组平均眼压为(23.10±3.92)mmHg(1kPa=7·5mmHg),术后8周A组平均眼压为(21.73±2.90)mmHg,B组平均眼压为(15.64±2.74)mmHg,C组平均眼压为(15.42±2·98)mmHg,B、C组与A组之间有显著性差异(P<0.05),B、C组间无显著差异(P>0.05)。B、C组8周植入材料有断裂现象,其周围有组织间隙和滤泡存在,无明显纤维组织增生;C组炎性细胞浸润现象好于B组;A组组织结构紊乱、瘢痕形成,未见组织间隙和滤泡。结论壳聚糖膜缓释给药系统作为小梁切除术的植入材料有良好的组织相容性,有一定抑制纤维组织增生的作用,能够有效维持滤过,降眼压效果满意。Objective To observe the reaction among tissues and the effects of decreasing intraocular pressure under the application of the chiotosan film atrigel in trabeculectomy. Methods Twenty-four New-Zealand rabbits（48 eyes） were randomly divided into 3 groups：group A with trabeculectomy as control group, group B with trabeculectomy plus implantion of chitossn film in intertaminal scleral flap, group C with trabeculectomy plus implantion of chitosan film atrigel in intertaminal scleral flap. Intraoctdar pressure（ IOP）, conjunctival follicle and pathological change were observed,morphological examination were made at 7 days,14 days,28 days,56 days after the surgery respectively. Results Before surgery, the average IOP of each group was （ 23. 10 ± 3.29） mmHg（ 1 kPa = 7.5 mmHg）.Eight weeks after operation, the IOP in group A,B, C was（21.73 ±2.90）mmHg, （15.64 ± 2.74）mmHg, （15.42±2.90）mmHg respectively, the difference between B,C and A was significant（P 〈0. 05） ,but there was no difference between B and C （ P 〉 0.05 ） ; Material implanted in group B and group C was fractured, and follicle and inter-tissue existed around, but no obvious expanded fibrous tissues appeared;The infiltration of inflammatory cells was better in group C than that in group B;Tissue structure in group A was in disorder and scar formed, but no follicle and inter-tissure existed. Conclusion Chitosan film atrigel has a good histocompatibility. It can inhibit fibrous tissue expansion, keep the rate of filter and decrease IOP effectively.

关 键 词：壳聚糖 缓释给药系统 小梁切除术 

分 类 号：R779.6[医药卫生—眼科]