巩膜条反折术、小梁切除联合羊膜植入治疗青光眼的效果及对血流动力学和血流变相关指标的影响  

Effect of Scleral Strip Reflex Durgery, Trabeculectomy Combined with Amniotic Membrane Implantation in the Treatment of Glaucoma and Its Influence on Hemodynamics and Hemorheology

作　　者：郑锦标 ZHENG Jinbiao(Dongguan People’s Hospital,Dongguan 523018,China)

机构地区：[1]广东省东莞市人民医院,广东东莞523018

出　　处：《中国医学创新》2020年第4期59-62,共4页Medical Innovation of China

摘　　要：目的:观察巩膜条反折术、小梁切除联合羊膜植入治疗青光眼的临床疗效及对血流动力学和血流变相关指标的影响。方法:选择2015年1月-2019年2月在本院眼科接受治疗的青光眼患者96例112眼作为研究对象,按照入院顺序随机分为观察组(46例56眼,采用巩膜条反折手术和小梁切除术联合羊膜植入术)和对照组(50例56眼,采用小梁切除联合羊膜植入手术);术后对两组患者随访3个月,观察两组血流变相关指标(全血高切黏度、血浆黏度、血细胞压积及全血低切黏度变化情况)、血流动力学相关指标[眼动脉舒张末期血流速度(EDV)、阻力指数(RI)及收缩期峰值血流速度(PSV)]变化情况、眼内压情况及术后不良反应发生情况。结果:两组术后1周、3个月全血高切黏度、血浆黏度、血细胞压积及全血低切黏度均显著低于术前(P<0.05),且观察组下降较对照组更为明显(P<0.05);观察组术后EDV、PSV均高于对照组(P<0.05),术后RI明显低于对照组(P<0.05),与术前比较差异均有统计学意义(P<0.05);两组术后1周、3个月眼压均低于术前(P<0.05),且观察组低于对照组(P<0.05);两组术后均未出现视网膜脱落、黄斑水肿及滤过泡相关性感染等不良反应。结论:巩膜条反折术、小梁切除联合羊膜植入术治疗青光眼近期疗效好,眼压控制效果显著,安全性高。Objective:To observe the clinical efficacy of scleral strip reflex surgery,trabeculectomy combined with amniotic membrane implantation in patients with glaucoma and its influence on hemodynamics and hemorheology related indicators.Method:A total of 96 glaucoma patients (112 eyes) of treated in our hospital from January 2015 to February 2019 were selected as the research objects.According to the order of admission,they were randomly divided into the observation group (46 cases of 56 eyes with Scleral strip reflex surgery and trabeculectomy combined with amniotic membrane implantation) and the control group (50 cases of 56 eyes with trabeculectomy combined with amniotic membrane implantation).The patients in two groups were followed up for3 months.The blood rheology related indicators (whole blood high-viscosity,plasma viscosity,hematocrit and whole blood low-cut viscosity),hemodynamic related indicators [ocular end-diastolic blood flow velocity (EDV),resistance index (RI),and peak systolic blood flow velocity (PSV)],intraocular pressure and postoperative adverse reactions of two groups were observed.Result:The high blood viscosity,plasma viscosity,hematocrit and whole blood low-cut viscosity of two groups after operation 1 week and 3 months were significantly lower than those of preoperative (P<0.05),the decrease in the observation group was more significant than that in the control group (P<0.05).The EDV and PSV of the observation group after operation were higher than those of the control group (P<0.05),RI after opration was significantly lower than that of the control group (P<0.05),the differences were statistically significant compared with before operatin (P<0.05).The intraocular pressure at 1 week and 3 months after operation were lower than those of before operation (P<0.05),and the observation group were lower than those of the control group (P<0.05).There were no adverse reactions such as retinal detachment,macular edema and filtering bleb-associated infection in two groups.Conclusion:Scleral strip refle

关 键 词：巩膜条反折术 小梁切除联合羊膜植入 青光眼 血流动力学 

分 类 号：R779.6[医药卫生—眼科]