巩膜潜池式小梁切除术联合新鲜羊膜移植术治疗闭角型青光眼患者的效果  

Effects of Scleral Submerged Trabeculectomy Combined with Fresh Amniotic Membrane Transplantation in Patients with Closed-Angle Glaucoma

作　　者：张茜 温心明 胡斌 ZHANG Qian;WEN Xinming;HU Bin(Department of Ophthalmology,People’s Hospital of Shangcheng County,Xinyang 465350,China;Department of Ophthalmology,Xinyang Central Hospital,Xinyang 464300,China)

机构地区：[1]商城县人民医院眼科,河南信阳465350 [2]信阳市中心医院眼科,河南信阳464300

出　　处：《河南医学研究》2022年第15期2809-2813,共5页Henan Medical Research

摘　　要：目的探究巩膜潜池式小梁切除联合新鲜羊膜移植术在闭角型青光眼(ACG)患者治疗中的应用价值。方法选取商城县人民医院2019年4月至2021年8月收治的106例ACG患者作为研究对象,按照随机数字法分为单一组和联合组,各53例。单一组接受巩膜潜池式小梁切除术治疗,联合组接受巩膜潜池式小梁切除联合新鲜羊膜移植术治疗。随访3个月评估两组疗效,对比术前、术后3个月最佳矫正视力(BCVA)、眼压、角膜内皮功能参数[最小细胞面积(MIN)、内皮平均细胞面积(AVE)、角膜内皮细胞密度(CD)]、血流动力学[眼动脉收缩峰值流速(PSV)、血浆黏度(PV)、阻力指数(RI)]、房水炎症介质白介素(IL)(IL-6、IL-12、IL-1β)水平。结果联合组总有效率(96.23%)高于单一组(83.02%)(P<0.05);术后3个月联合组眼压、BCVA较单一组低(P<0.05);术后3个月联合组CD、AVE、MIN高于单一组(P<0.05);术后3个月联合组PSV高于单一组,PV、RI低于单一组(P<0.05);术后3个月联合组IL-6、IL-12、IL-1β水平低于单一组(P<0.05)。结论巩膜潜池式小梁切除术联合新鲜羊膜移植术治疗ACG患者效果确切,可降低眼压,恢复视功能,其作用可能与抑制炎症反应、血流动力学恢复及角膜内皮功能改善有关。Objective To investigate the value of scleral submerged trabeculectomy combined with fresh amniotic membrane grafting in the treatment of patients with angle-closure glaucoma(ACG).Methods A total of 106 patients with ACG treated in Shangcheng County People’s Hospital from April 2019 to August 2021 were selected as the research objects,and were randomly divided into single group and combined group,with 53 cases in each group.The single group received scleral cistern trabeculectomy,and the combined group received scleral cistern trabeculectomy combined with fresh amniotic membrane transplantation.The curative effects of the two groups were evaluated after 3 months of follow-up,and the best corrected visual acuity(BCVA),intraocular pressure,corneal endothelial function parameters[minimum cell area(MIN),average endothelial cell area(AVE),corneal endothelial cell density(CD)],hemodynamics[ophthalmic artery peak systolic flow velocity(PSV),plasma viscosity(PV),resistance index(RI)],aqueous humor inflammatory mediators interleukin(IL)(IL-6,IL-12,IL-1β)levels were compared before and 3 months after operation.Results The total effective rate of the combined group(96.23%)was higher than that of the single group(83.02%)(P<0.05).Three months after operation,the intraocular pressure and BCVA of the combined group were lower than those of the single group(P<0.05).Three months after operation,CD,AVE and MIN in the combined group were higher than those in the single group(P<0.05).Three months after operation,PSV in the combined group was higher than that in the single group,and PV and RI were lower than that in the single group(P<0.05).Three months after operation,the level of IL-6,IL-12,IL-1β in the combined group was lower than that of the single group(P<0.05).Conclusion Scleral submerged trabeculectomy combined with fresh amniotic membrane transplantation is effective in the treatment of ACG patients,which can reduce intraocular pressure and restore visual function.Its effect may be related to the inhibition of inflammato

关 键 词：闭角型青光眼 巩膜潜池式 小梁切除术 羊膜移植术 最佳矫正视力 

分 类 号：R775[医药卫生—眼科]