巩膜通道重建术联合结膜下注射5-Fu、Healon治疗功能不良滤过泡的临床观察  

The clinical observation of scleral tunnel reconstruction combined with subconjunctival injection of 5-FU and Healon in the treatment of dysfunctional filtering blebs

作　　者：冯建辉 韩延燕 FENG Jianhui;HAN Yanyan(Department of Ophthalmology,Central Hospital ofLijin,Lijin 257400,China,Province,China)

机构地区：[1]利津县中心医院眼科,山东东营257400

出　　处：《实用防盲技术》2023年第1期12-15,26,共5页Journal of Practical Preventing Blind

摘　　要：目的探讨巩膜通道重建术联合结膜下注射5-Fu、Healon在治疗青光眼术后功能不良滤过泡中的效果,为临床诊治功能不良滤过泡提供新的思路。方法2014年01月至2018年10月于利津县中心医院行青光眼滤过性手术后早期滤过泡失败并连续随访的76例77只眼,采用数字表将其分为治疗组和对照组,治疗组38例(39只眼),对照组38例(38只眼)。治疗组行巩膜通道重建术联合术中在巩膜通道弥漫注入0.4ml透明质酸钠(Healon),术后于鼻上方分离的球结膜下注射5mg 5-氟尿嘧啶(5-Fu),每5天1次,共2次;对照组行眼球按摩,随诊1年,观察并记录1个月、3个月、6个月、12个月两组患者滤过泡、眼压情况,并进行比较。结果(1)两组滤过泡对比,根据Kronfeld滤过泡分型法,Ⅰ、Ⅱ型滤过泡为功能性滤过泡,Ⅲ,Ⅳ型滤过泡为非功能性滤过泡,治疗后1个月,两组比较差异有统计学意义(x^(2)=4.745,P=0.032);治疗后3个月,两组比较差异有统计学意义(x^(2)=3.988,P=0.044);治疗治疗后6个月,两组比较差异有统计学意义(x^(2)=4.426,P=0.039);治疗后12个月,两组比较差异有统计学意义(x^(2)=7.113,P=0.004);(2)眼压:治疗组,治疗后1、3、6、12个月与治疗前比较,差异均有统计学意义(P<0.05);治疗后1、3、6、12个月,两组相比较,差异有统计学意义(P<0.05);(3)治疗后1、3、6、12个月,两组成功率相比,差异有统计学意义(P<0.05)。结论巩膜通道重建术联合结膜下注射5-Fu、Healon治疗功能不良滤过泡,眼压稳定,术后成功率高,操作简单易操作,适合于基层医院推广。Objective Through the treatment of dysfunctional filtering blebs after glaucoma surgery by scleral channel reconstruction combined with subconjunctival injection of 5-FU and Healon,which provides new ideas for clinical diagnosis and treatment of dysfunctional filtering blebs.Methods From January 2014 to October 2018,A total of 76 cases(77 eyes) were followed up continuously,whofailed early filtration blebs after glaucoma filtration surgery in Central Hospital of Lijin,The patients were divided into treatment group and control group by numerical table,38 patients(39 eyes) in treatment group and 38 patients(38eyes) in control group.The treatment group received scleral channel reconstruction combined with intraoperative injection of 0.4ml sodium hyaluronate(Healon) into scleral channel diffused,and 5mg 5-fluorouracil(5-FU) was injected into the bulbar conjunctiva separated above the nose,once every 5 days,twice in total,while the control group received eye massage.After 1 year of follow-up,the filtration bubble and intraocular pressure were observed at 1 month,3 months,6 months and 12 months after treatment,and the results were compared.Results(1) The filtering bleb function of two groups,According to Kronfeld filtering bleb classification method,Ⅰ、Ⅱ type filtering bleb is a functional filtering bleb,Ⅲ,Ⅳ type filtering bleb is a unfunctional filtering bleb,One month after treatment,the difference between the two groups was statistically significant(x^(2)=4.745,P=0.032);Three months after treatment,the difference between the two groups was statistically significant(x^(2)=3.988,P=0:044);Six months after treatment,the difference between the two groups was statistically significant(x^(2)=4.426,P=0.039),Twelve months after treatment,the difference between the two groups was statistically significant(x^(2)=7.113,P=0.004);(2) Intraocular pressure:In the treatment group,1,3,6,and 12 months after treatment were compared with those before treatment,the difference was statistically significant(P <0.5);Intraocular pre

关 键 词：下斜肌功能亢进巩膜通道重建 5-氟尿嘧啶 明质酸钠 功能不良滤过泡 

分 类 号：R779.6[医药卫生—眼科]