小梁切除术中植入西罗莫司药载羊膜的研究  

Study of Amnion Implantation with Sirolimus Applied in Glaucoma Trabeculectomy

作　　者：骆荣江[1] 李小敏[2] 田臻[3] 刘韶瑞[1] 颜志超[1] 卓业鸿[3] 

机构地区：[1]中山大学附属第一医院眼科,广州市510080 [2]南方医科大学附属珠江医院,510282 [3]中山大学中山眼科中心,510048

出　　处：《中华全科医学》2010年第8期942-943,共2页Chinese Journal of General Practice

基　　金：广东省科技计划基金资助项目(2008B030301083)

摘　　要：目的观察结膜瓣下西罗莫司载药羊膜植入在兔眼小梁切除术中应用的效果。方法新西兰白兔32只(64眼),全麻下前房注入2%甲基纤维素制成高眼压模型。实验眼分成4组,每组16眼,在施行小梁切除时,分别行羊膜植入(A组),西罗莫司载药羊膜植入(B组),丝裂霉素C(C组),未使用任何药物(D组)。术后观察眼压、滤过泡、并发症等情况。结果①术后90d眼压:A组(18.23±3.90)mmHg(1mmHg=0.133kPa),B组(13.18±2.24)mmHg,C组(14.98±3.33)mmHg,3组眼压值均显著低于D组的(25.01±1.23)mmHg(t分别为4.132;6.487;5.986,P<0.05);但A组眼压值较C组(阳性对照)高,差异有统计学意义(t=2.794,P<0.05);②术后90d具有功能性滤过泡者:A组12眼(12/16,75%);B组15眼(15/16,93.75%);C组14眼(14/16,87.5%),前3组与D组8眼(8/16,50%)相比,功能性滤过泡数差异均有统计学意义(χ2分别为4.907;6.596;5.162,P<0.05);③并发症:除C组2眼发生脉络膜脱离外,其余各组均未发生此并发症。结论西罗莫司载药羊膜植入能提高兔眼小梁切除术的成功率且无明显的手术并发症。Objective To observe the effect of bio-amnion implantation with Sirolimus in conjunctive flap applied in refractory glaucoma trabeculectomy in rabbits.Methods Thirty-two New Zealand white rabbits（64 eyes）were used as model.The ocular hypertension was induced by injecting 2% methyl cellulose into anterior chamber of the rabbits.The rabbits were divided into 4 groups（16 eyes in each group）.After trabeculectomy,group A received amniotic membrane implantation,group B received bio-amnion implantation with Sirolimus,group C received mitomycin,and group D did not receive any medicine was as control.The intraocular pressure,filtrate bleb and complications were observed.The follow-up was 30 months.Results Post-operative intraocular pressure were（18.23±3.90）mm Hg in group A,（13.18±2.24）mm Hg in group B,（14.98±3.33）mm Hg in group C,and（25.01±1.23）mm Hg in group D,respectively.The difference between group D and other groups had statistical significance（t=4.132,6.487,5.986,P0.05）.90 days later,the ratio of sustained filtration bleb was 12/16（75%）in group A,15/16（93.75%）in group B,14/16（87.5%）in group C,8/16（50%）in group D,respectively.There were statistical differences in the disappearance number of filtration bleb between group D and other groups（χ2=4.907,6.596,5.162,P0.05）.There were two eyes with choroidal detachment in group C,none complications in other groups.Conclusion Bio-amnion implantation in conjunctive flap,with a less complication,can effectively improve the achievement ratio in refractory glaucoma trabeculectomy.

关 键 词：小梁切除术 西罗莫司 羊膜 植入 

分 类 号：R775[医药卫生—眼科] R779.62[医药卫生—临床医学]