丝裂霉素C在小梁切除术中应用的临床观察  

Clinical observion about application mitomycin C on trabeculectomy

作　　者：周琼[1] 熊惠芳[1] 刘新华[1] 刘永琰[1] 

机构地区：[1]江西医学院一附院眼科,南昌330006

出　　处：《江西医药》1999年第6期331-333,共3页Jiangxi Medical Journal

摘　　要：目的　观察０ ．３／ ｍｌ 的丝裂霉素Ｃ（ Ｍ ＭＣ） 作用时间３ ｍｉｎ 对青光眼小梁切除术疗效的影响及其并发症的防治。方法　选择３０ 例４３ 眼青光眼在小梁切除术中应用Ｍ ＭＣ，３０ 例４５ 眼青光眼单纯行小梁切除术作为对照组，术前两组患者资料统计学处理无差异。观察两组术前：术后眼压、滤过泡、前房、并发症等，并将结果作统计学处理。随访时间６ ～２４ 月，平均１２ ±２ ．６ 月。结果　两组术后眼压均较术前显著降低，术后前房恢复时间无差异。Ｍ ＭＣ 组多表现为苍白隆起壁较薄滤泡，对照组多为弥漫扁平充血滤泡， ＭＭＣ 组术后成功率为９７ ．６ ％ ，对照组成功率８４ ．４４ ％ ，有统计学差异。术后并发症Ｍ ＭＣ组主要是低眼压，但未发现有持续性低眼压性黄斑病变者，其余并发症有结膜创口漏、脉胳膜脱离及白内障加重，两组无差异。结论　０ ．３ ｍ ｇ／ ｍｌＭＭＣ 作用时间３ ｍｉｎ 可提高抗青光眼小梁切除术的成功率，强调严格选择适应症，术中彻底清除残余ＭＭＣ，预防低眼压等并发症。Objective\ To assess the efficacy and complicafion of mitomycin C in treatment of trabeculectomy.Methods\ trabeculectany were performed with intraoperative application of cotton plate soak by mitomycin C (MMC) 0.3mg/ml for 3 min on 43 eyes of 30 cases of glaucoma patients was MMC group.45eyes of 30 cases without MMC as control group.There were no statistic significance of preoperative data between two groups (P>0.05) Intraocular pressure (IOP),filtrative bleb,anterior chamber and complication were observed and compare after operation.All cases were followed up,at a mean perid of 12±2.6m .Results\ The total success rate of MMC group and control group were 97.07% and 84.44% respectively (P<0.05).After operation IOP were decreased in both groups .Althoug there were no signifigantly difference in IOP between two group postoperatin within 2 weeks (P<0.05),but after Im to 3m,IOP elavation range were lower and the elevating period were longer in the MMC group than conrol group (P<0.05).There were no significant different in changes of anterior chamber between two group,but the filtrating bleb were puite different,it were white,swelling up and thin wall in MMC group and were more congested dispersely and flat in the control group.The main complication of MMC group were more lower IOP than control group(P<0.05),Other complication were few and had no difference between two group (P<0.05).Conclusion\ Application of MMC intraopration can increase the success rate in trabeculectomy of glucoma.But the indicaltion must chose strictly and the remaining MMC must clean away completely intraoperation,for the preventing complication of low IOP and others.

关 键 词：青光眼 小梁切除术 丝裂霉素C 

分 类 号：R775.05[医药卫生—眼科]