可拆除缝线技术在小梁切除术中应用的循证评价  

The Systematic Review of Trabeculectomy with Releasable Sutures

作　　者：冯梅艳[1] 张前卫[1] 

机构地区：[1]山东枣庄市立医院,山东枣庄277100

出　　处：《中国现代医生》2008年第24期31-33,共3页China Modern Doctor

摘　　要：目的将目前有关可拆除缝线技术在小梁切除术中应用的文献按照循证医学的要求进行系统评价,以期能为该治疗方式的临床应用提供较为可靠的证据,设计系统评价。方法检索MEDLINE、中国生物医学文献期刊数据库中2008年1月前的英文及中文文献,依据纳入标准和排除标准筛选后剩余文献按照治疗性医学证据级别的判定标准进行证据分级,并按照终点指标进行证据评价。以眼压、浅前房发生率、滤过泡的成功率、其他并发症、长期眼压控制为主要指标。结果11篇文献入选,Ⅰ级证据0篇,Ⅱ级证据10篇,Ⅲ级证据1篇,Ⅳ级证据0篇。在降眼压方面,8篇文献报道术后3个月试验组和对照组差异无显著性意义,仅2篇文献报道两组差异有显著性意义;在预防浅前房的发生率方面,11篇文献都显示可拆除缝线技术的应用能够显著降低浅前房的发生率,降低并发症;5篇文献评价两组的功能性滤过泡成功率差异无显著性,2篇评价差异有意义,4篇未观察滤过泡。结论本次评价表明可拆除缝线技术的应用能够减少小梁切除术后并发症的发生率,在对长期降眼压及功能性滤过泡的形成方面还需大样本的随机对照试验的长期观察。Objective To make a systematic review of trabeculectomy with releasable sutures by the rule of evidenced-based medicine,to assess the safety and effect of this therapy for future clinic use and design systematic review. Methods A systematic review of all the relevant references was performed. The references were identified from Medline,Chinese bio-medicine Database. According to the inclusion and exclusion criterion,the evidence qualities were classified by the grades of the evidence quality for the therapy articles, Then we assessed the evidence by the final targets. Main outcome measures IOP anterior chamber,the incidence of shallow anterior chamber and related complications. The success rates of functional filtering blebs. The long-term IOP control. Results We assessed eleven articles, in which none was in grade I , 10 were in grade Ⅱ, 1 was in grade Ⅲ. There was no statistical significant difference in lowering IOP between two groups after three months. The incidence of shallow anterior chamber and related complications occurred statistically significantly less in the group with releasable sutures than in the group without releasable sutures. The success rate of functional filtering bleb there were no statistically significantly difference between two group. Conclusion The review showed that using releasable sutures is an effective way to minimize the incidence of shallow anterior chamber and related complications of trabeculectomy. It is need a large sample randomize-controlled-trial to review the effective of using releasable sutures in lowing long-term IOP and the success rate of functional filltering bleb.

关 键 词：小梁切除术 可拆除缝线 系统评价 

分 类 号：R775.2[医药卫生—眼科]