针刺分离联合5-氟尿嘧啶注射治疗功能不良滤过泡的临床观察

发布时间：2018-10-26 18:12

【摘要】：目的:观察针刺分离联合5-氟尿嘧啶(5-FU)结膜下注射治疗青光眼小梁切除术后不同时期功能不良滤过泡的临床疗效、影响因素及安全性。方法:对76例83眼小梁切除术后功能不良滤过泡进行针刺分离联合5-FU结膜下注射,针刺分离后随访12mo,对随访时患者的眼压(intraocular pressure,IOP)、用药次数、角膜内皮、滤过泡的形态及并发症进行观察记录。结果:针刺分离前患者的眼压为35.3±5.8mm Hg(1k Pa=7.5mm Hg),随访结束时眼压为17.0±4.3mm Hg,两者差异有显著统计学意义(t=24.846,P0.01);术前平均用药种类为1.7±0.9种,随访结束时平均用药种类为0.4±0.7种,两者差异有显著统计学意义(t=11.145,P0.01)。针刺分离12mo后滤过泡成功率为89.2%,其中完全成功率为69.9%,Kaplan-Meier生存分析示83眼平均生存时间为11.0mo(95%CI:10.3~11.6)。青光眼的类型、滤过手术是否使用丝裂霉素C(mitomycin C,MMC)、患者年龄及滤过手术至针刺分离的间隔时间对针刺分离效果无影响,针刺分离前滤过泡形态对针刺分离效果有影响,包囊型滤过泡较扁平型滤过泡针刺分离效果好,滤过手术后3mo内进行针刺分离的患者比3mo的患者平均针刺分离的次数明显减少。结论:针刺分离联合5-FU结膜下注射是治疗小梁切除术后功能不良滤过泡的一种安全、有效的简单处理方法,小梁切除术后发现功能不良滤过泡应早期处理。
[Abstract]:Objective: to observe the clinical efficacy, influencing factors and safety of acupuncture separation combined with 5 fluorouracil (5-FU) subconjunctival injection in the treatment of dysfunctional filtration bleb after trabeculectomy. Methods: after trabeculectomy, 83 eyes of 76 patients with dysfunctional filtering blebs were treated with acupuncture separation combined with 5-FU subconjunctival injection. The intraocular pressure (intraocular pressure,IOP), the times of medication, and corneal endothelium were followed up for 12 months after acupuncture separation. The morphology and complications of the bleb were observed and recorded. Results: the intraocular pressure (IOP) was 35.3 卤5.8mm Hg (17.0 卤4.3mm Hg,) at the end of 1 k Pa=7.5mm Hg), follow-up (t = 24.846 卤P0.01). The average kinds of drugs were 1.7 卤0.9 before operation and 0.4 卤0.7 at the end of follow-up. There was a significant difference between the two groups (t = 11.145, P 0.01). The success rate of bleb filtration was 89.2 after acupuncture separation of 12mo, and the complete success rate was 69.9%. Kaplan-Meier survival analysis showed that the average survival time of 83 eyes was 11.0mo (95%CI:10.3~11.6). The type of glaucoma, whether or not mitomycin C (mitomycin was used in filtering operation, the age of the patient and the interval between filtration operation and acupuncture separation had no effect on the effect of acupuncture separation. The effect of acupuncture separation was influenced by the morphology of filtration bubble before acupuncture separation. The results showed that the vesicular filtration bleb was better than that of flat filter bleb. The average times of acupuncture separation in 3mo patients after filtration surgery were significantly lower than those in 3mo patients. Conclusion: acupuncture separation combined with subconjunctival injection of 5-FU is a safe and effective method for the treatment of dysfunctional filtering bleb after trabeculectomy.
【作者单位】：青岛大学附属医院眼科;
【分类号】：R779.6

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