靴带式连续缝合结膜瓣切口预防小梁切除术后早期浅前房临床观察  

Analysis of the effect of shoelace continuous suture for conjunctival incision on preventing postsurgical shallow anterior chamber

作　　者：陆融[1] 林菁[1] 臧涵怡[1] 

机构地区：[1]南京医科大学附属无锡市人民医院眼科,江苏省无锡市214000

出　　处：《中国实用眼科杂志》2017年第4期389-392,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 观察小梁切除术中相采用靴带式连续缝合以上穹窿为基底的结膜瓣切口预防术后早期浅前房的作用.方法 临床病例对照研究.选取2011年3月至2016年3月在无锡市人民医院眼科收治的双眼原发性青光眼,并先后行双眼青光眼小梁切除术的患者41例82只眼纳入研究.患眼均作以上穹窿为基底的结膜瓣切口行小梁切除术,随机选一眼为观察组,关闭结膜瓣切口时采用靴带式连续缝合将结膜瓣缝合在对应的角膜面上,以覆盖巩膜瓣根部两侧切口为度;同一患者另一眼为对照组,关闭结膜瓣切口时将结膜瓣间断缝合.观察术后3d、1周及1月眼压及前房深度.结果 观察组术后3d眼压完全成功控制38只眼,条件成功控制3只眼,无失败眼,有效率100％;术后1周及1月眼压完全成功控制37只眼,条件成功控制3只眼,失败1只眼,有效率均为97.56％;对照组术后3d眼压完全成功控制39只眼,条件成功控制2只眼,无失败眼,有效率100％;术后1周眼压完全成功控制38只眼,条件成功控制2只眼,失败1只眼,有效率97.56％;术后1月眼压完全成功控制37只眼,条件成功控制2只眼,失败2只眼,有效率95.12％,两组有效率比较差异无统计学意义（P＞0.05）.观察组术后3d发生浅前房共6只眼,均为I级浅前房,发生率为14.63％,未予特殊处理,术后1周前房深度恢复,术后1月复查稳定;对照组术后3d发生浅前房共12例,发生率为29.26％,显著高于观察组（X^22=18.76 P＜0.01）;其中I级浅前房7例,Ⅱ级浅前房4例,Ⅲ级浅前房1例,Ⅱ级＋ⅡⅢ级浅前房眼发生率（5/41 12.19％）显著高于对照组（0/41） （x2=24.4 P＜0.01）.其中I级浅前房未予特殊处理,术后l周内前房深度恢复,Ⅱ及Ⅲ级浅前房患眼予放瞳、加压包扎、限制活动等处理,术后1～2周前房深度恢复,术后1月复查稳定.结论 小梁切除术中相采用靴带式连续缝合以上穹窿为基底的结膜瓣切口对预防Objective To analyze the effect of shoelace continuous suture for conjunctival incision on preventing postsurgical shallow anterior chamber.Methods Forty-one patients （82 eyes） diagnosed as primary glaucoma,and treated with trabeculectomy were included in this study during the period from March 2011 to March 2016.One eye,which was randomly chosen and applied shoelace continuous suture to attach the conjuctival fomix flap to the cornea,was included in observation group;the other eye,which under went same surgical procedure but applied conjuctival interrupted suture,was included in the control group.Intraocular pressure （IOP） and anterior chamber depth was measured and recorded after 3 days,1 week and 1 month after surgery.Results Among the observation group,3 days after surgery,IOP of 38 eyes was successfully controlled,IOP of 3 eyes was partially successfully controlled,with control rate as 100%;1 week and 1 month after surgery,IOP of 37 eyes was successfully controlled,IOP of 3 eyes was partially successfully controlled,IOP of 1 eye was failed to control,with control rate as 97.56%.Among the control group,3 days after surgery,IOP of 39 eyes was successfully controlled,IOP of 2 eyes was partially successfully controlled,with control rate as 100%;1 week after surgery,IOP of 38 eyes was successfully controlled,IOP of 2 eyes was partially successfully controlled,IOP of 1 eye was failed to control,with control rate as 97.56%;1 month after surgery,IOP of 37 eyes was successfully controlled,IOP of 2 eyes was partially successfully controlled,IOP of 2 eye was failed to control,with control rate as 95.12%.No significant difference was observed between two groups （P 〉0.05）.Six eyes （6/41,14.63%） had I degree shallow anterior chamber 3 days after surgery among the observation group,all recovered within 1 week without treatment,and remained stabilized 1 month after surgery;12 eyes with shallow anterior chamber after surgery occurred in control group （12/41,29.26%）,significantly more than the observe gr

关 键 词：靴带式连续缝合 小梁切除术 前房 

分 类 号：R775.05[医药卫生—眼科]