改良小梁切除术治疗青光眼高眼压持续状态的临床分析  

Clinical analysis of modified trabeculectomy in glaucoma surgery with high elevated intraocular pressure

作　　者：张沧霞[1] 郑艳霞[1] 孙卧林[2] 王庆金[1] 张金秀[2] 崔艳琨[1] 

机构地区：[1]河北医科大学沧州中西医结合临床医学院眼科,中国河北省沧州市061001 [2]河北医科大学沧州中西医结合临床医学院麻醉科,中国河北省沧州市061001

出　　处：《国际眼科杂志》2013年第10期2042-2044,共3页International Eye Science

摘　　要：目的:回顾性分析改良小梁切除术治疗青光眼持续高眼压状态的临床资料,评价改良小梁切除术的效果。方法:青光眼持续高眼压状态患者100例100眼,分为治疗组55例55眼和观察组45例45眼。治疗组采用改良小梁切除术,观察组采用常规小梁切除术。改良措施主要有:术前星状神经节阻滞降眼压,采用表面麻醉和20g/L利多卡因棉片巩膜面浸润麻醉;用隧道刀做板层巩膜瓣;在小梁切除部位做前房穿刺,慢放房水;术中置巩膜瓣调整缝线;术中散瞳,术毕睫状肌麻痹剂应用。结果:治疗组手术并发症发生率低于观察组,两组比较差异有统计学意义(P<0.05)。随访3mo,治疗组眼压低于观察组,两组比较差异有统计学意义(t=9.1535,P<0.05)。治疗组平均住院天数少于观察组(t=39.8010,P<0.01)。治疗组平均住院费用低于观察组(t=11.3219,P<0.01)。结论:改良小梁切除术治疗青光眼持续高眼压状态不仅挽救部分视功能,减少手术严重并发症发生率,术后眼压控制更好,还可以缩短平均住院日,减少医疗费用,从而提高了患者满意度。AIM： To make a retrospective analysis of the clinical data of modified trabeculectomy in treating glaucoma surgery with high elevated intraocular pressure retrospectively and evaluate the effect of modified trabeculectomy. METHODS： One hundred acute angle - closure glaucoma patients （100 eyes） with persistent high intraocular pressure were divided into treatment group （45 eyes） and control group （55 eyes）. Patients in treatment group was treated with by trabeculectomy, while those in control group received modified trabeculectomy. The modified measures include stellate ganglion block preoperative , topical anesthesia and local anesthesia with 20g/L lidocaine cotton-piece, to make scleral flap with sclerotome, to release aqueous humor outflow slowly after paracentesis of anterior chamber, and using mydriatic and cycloplegic during and after surgery. RESULTS： The incidence of operation complicationin control group was lower than that in treatment group. The differences were statistically significant （P〈0.05. The intraocular pressure of control group was lower than that of treatment group after 3 months follow-up. The differences were statistically significant （ t= 9. 1535, P〈0.05 ）. The average hospitalization days and the expenses in the hospital of the control group were lower than that of the treatment group. The differences were statistically significant （ t= 39.8010, P〈0.01 i t= 11. 3219, P〈 0.01）. CONCLUSION- The modified trabeculectomy applied in the treatment of glaucoma with persistent high intraocular pressure can not only save the visual function of connection part to a certain extent, but also reduce the incidence of serious complications. It can obtain better intraocular pressure, shorten the average hospitalization days, decrease the expenses and increase patients satisfaction.

关 键 词：青光眼 改良小梁切除术 高眼压 平均住院日 

分 类 号：R779.6[医药卫生—眼科]