醛化脐带静脉管在兔眼非穿透性小梁手术中的应用  

Experimental study on the application of human umbilical vein in non-penitrating trabecular surgery

作　　者：潘璐[1] 高殿文[2] 石磊[2] 聂庆珠[2] 宋光辉[1] 

机构地区：[1]上海瑞金医院集团闵行区中心医院眼科,中国上海市201100 [2]中国医科大学附属盛京医院眼科,中国辽宁省沈阳市110003

出　　处：《国际眼科杂志》2008年第11期2206-2209,共4页International Eye Science

基　　金：中国辽宁省教育厅科研基金资助项目(No.202013128)~~

摘　　要：目的:观察脐带静脉管在兔眼非穿透性小梁手术(non-pen-itrating trabecular surgery,NPTS)中抗瘢痕化及其毒副作用。方法:对30只家兔双眼行NPTS,按照自身对照原则,术中一眼于深层巩膜切除处放置经醛化脐带静脉管组成实验组,另一眼不植入为对照组。术后观察眼压、滤过泡和眼局部反应,并做组织学及超声生物显微镜(UBM)检查。结果:术后1～5wk滤过泡存留例数实验组大于对照组(P<0.05);术后3d及6wk以后两组差异无显著性。术前眼压两组差异无显著性,术后1～8wk实验组低于术前,对照组术后1～2wk眼压低于术前(P<0.05),术后1～8wk实验组平均眼压低于对照组(P<0.05)。对照组术后2wk减压房被纤维组织充填,滤过道关闭,实验组术后28wk房水减压房内仍可见脐带静脉管,与周围瘢痕组织不发生紧密粘连,滤过道仍存在。术后1～28wkUBM检查脐带静脉管未降解,减压房仍然存在。术后:前房出血2眼(两组各1例),高眼压1眼(对照组),其余两组在观察期内均无明显炎症反应,植入物未见裸露及被排出现象。结论:醛化脐带静脉管可在家兔非穿透性小梁手术中防止滤过道粘连,维持巩膜间腔的存在,有效地降低眼压,无免疫排斥反应。AIM： To experimentally evaluate the effects of human umbilical vein tube implant in non-penitrating trabecular surgery （NPTS） and its toxic and side effects. METHODS： Thirty rabbits underwent bilateral non- penitrating trabecular surgery. An umbilical vein tube was sutured in the scleral bed in one eye, while the other eye served as the control. Intraocular pressure （ IOP）, filtering bleb, intraocular reactions, histological exams and ultrasound biomicroscopy （UBM） exams of the surgical area were performed postoperatively. RESULTS： Three days after surgery, the bleb formation was similar in two groups. From the 1^st to the 5^th postoperative week, the number of existing functional bleb in the experimental group was significantly higher than that in the control group （P〈 0.05）, and there was no statistical difference between the two groups after 6 weeks. Eyes in the experimental group showed longer postoperative lOP-reduction periods than those in the control group （8 weeks vs 2 weeks）. From the 1^st to the 8th week after surgery, the decreasing of intraocular pressure in the experimental group was significantly greater than that in the control group （P 〈 0. 05）. Histological observation showed that in the control group fibroblastic proceeded to completely fill with fibrin clots and fibroblasts by postoperative day 7. In the experimental group, the decompression space was detectable at all histology study periods. The implant can still be seen at the operative site up to week 28 postoperatively. In the postoperative 1-28 weeks, UBM exam showed that the implant was not degraded and the decompression space and still been seen. Mild hyphema occurred in 2 eyes and intraocular hypertension occurred in 1 eye postoperatively. No signs of significant inflammations were observed in other individuals of the two groups during the 28 weeks study, and no signs of foreign-body reaction were detected in all the eyes with umbilical vein implant. CONCLUSION： The use of human umbilical vein i

关 键 词：脐带静脉管 非穿透性小梁手术 青光眼 

分 类 号：R779.6[医药卫生—眼科]