人羊膜与丝裂霉素C用于青光眼小梁切除术的临床对比研究  

A Clinical Comparative Study of Human Amniotic Membrane with Mitomycin C Applied in Glaucoma Trabeculectomy

作　　者：高伟[1] 崔巍[1] 刘森玉[2] 陈小海[1] 张桂荣[1] 贺燚[3] 

机构地区：[1]内蒙古自治区医院眼科,010011 [2]内蒙古医学院第一附属医院眼科 [3]河南省眼科研究所

出　　处：《中国实用眼科杂志》2002年第8期623-625,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 :探讨羊膜与丝裂霉素C (MMC)应用于小梁切除术的临床疗效。方法 :采用随机对照的方法 ,施行同一标准的小梁切除术 ,将 2 6例 (4 2眼 )闭角型青光眼患者分为羊膜组和MMC组各 2 1眼。前者施行小梁切除术联合巩膜瓣下羊膜植入术 ,后者在术中一次性应用MMC ,浓度为 0 2 5mg/ml ,共 5分钟。随访 6个月。结果 :手术成功率 :羊膜组的累积完全成功率和条件成功率分别为 86 2 3 %和 96 68% ,MMC组的累积完全成功率和条件成功率分别为 5 8 79%和 79 5 6% (P <0 0 1)。功能性滤过泡的累积存活率羊膜组为 86 2 6% ,MMC组为 5 1 3 3 % ,两组之间有显著性差异 (P <0 0 1)。术后视力 :MMC组术后视力下降者 10眼 (4 7 6% ) ,羊膜组则只有 2眼 (11 8% )。两组间差异有显著性 (P <0 0 5 )。并后并发症 :羊膜对眼部的副作用小 ,引起的并发症主要有术后浅前房 ;MMC引起的眼部并发症主要有薄壁滤过泡、术后浅前房、滤过泡渗漏、前房出血、持续性低眼压、低眼压性黄斑病变等。结论 :羊膜应用于小梁切除术可有效地防止滤过泡的瘢痕组织形成 ,并能有效长期保留功能性滤泡 。To probe the results of trabeculectomy with hu man amniotic membrane (HAM) or mitomycin C (MMC) in the treatment of glaucoma. Methods:In a randomized control clinical trial,42 eyes of 26 patients with angle closure glaucoma were underwent trabeculectomy with HAM or MMC,respectively,each group consisting of 21 eyes.The former was trabeculectomy with HAM transplanted under the scleral flap;the later was intraoperatively administered with MMC,0.25mg/ml via a sponge under the conjunctival flap for 5 minutes.The follow up was 6 months. Results:The cumulative complete success rate and the quali fied success rate in HAM group were 86.23% and 96.68% respectively.And that in MMC group were 58.79% and 79.56%,respectively.The difference between the two groups was significant (P<0.01).The cumulative percentage of functioning bleb in HAM was 86.26%,and that in MMC group was 51.33% (P<0.01).The decrease of visual acuity was seen in 47.6% of the group members (10 eyes) in MMC group,whereas only 11.8% (2 eyes) in HAM group (P<0.05).Complications induced by HAM were rare,mainly involving the shallow anterior chamber,whereas by MMC involving anterior chamber hemorrhage,thin wall bleb,bleb leaking,persistent hypotony and hypotonous maculopathy and so on. Conclusions:Application HAM in trabeculectomy can prevent the bleb from scar formation and can maintain the functional bleb long time.

关 键 词：人羊膜 丝裂霉素C 青光眼 小梁切除术 临床 对比研究 

分 类 号：R779.6[医药卫生—眼科] R775[医药卫生—临床医学]