兔眼小梁切除术中丝裂霉素C放置部位对手术效果的影响

发布时间：2018-04-29 01:26

本文选题：青光眼 + 小梁切除术　；参考：《山东医药》2015年36期

【摘要】：目的探讨兔眼小梁切除术中丝裂霉素C(MMC)放置部位对其房水残存浓度及巩膜滤过道组织病理学的影响。方法将45只新西兰大白兔随机分为结膜瓣组、巩膜瓣组、对照组各15只,均常规行小梁切除术。结膜瓣组及巩膜瓣组术中将浸在浓度为0.2 mg/m L MMC中的海绵片分别放置于结膜瓣及巩膜瓣下,120 s后移除,用乳酸林格液连续冲洗眼表组织;对照组不予任何药物处理。各组分别于乳酸林格液冲洗后5、30、60 min采用高效液相色谱分析仪检测房水MMC浓度,术后1、7、14天于光学显微镜下观察滤过道瘢痕形成情况及功能性滤过泡数量。结果结膜瓣组、巩膜瓣组房水MMC残存浓度均呈先升高后降低趋势,均于用药后30 min达到最高峰。用药后5 min结膜瓣组、巩膜瓣组房水MMC残存浓度分别为(14.95±4.26)、(44.81±8.42)ng/m L,30 min分别为(27.26±6.33)、(74.52±6.27)ng/m L,60 min分别为(2.99±0.79)、(17.89±6.85)ng/m L,P均0.05;结膜瓣组、巩膜瓣组组内各时点比较,P均0.05。各组术后1、7天滤过道均开放;术后14天,结膜瓣组、巩膜瓣组仍存在有效滤过道,对照组滤过道被纤维结缔组织阻塞。各组术后1、7、14天对功能性滤过泡形成数量进行比较,P均0.05。结论兔眼小梁切除术中于结膜瓣、巩膜瓣下放置浓度为0.2 mg/m L的MMC后均可形成有效滤过道,但是前者房水残留浓度较低,相对更安全。
[Abstract]:Objective to investigate the effect of mitomycin C MMC (MMC) placement in trabeculectomy on the residual concentration of aqueous humor and histopathology of scleral filtration passageway. Methods 45 New Zealand rabbits were randomly divided into conjunctival flap group, scleral flap group and control group. In the conjunctival flap group and the scleral flap group, the sponge slices immersed in 0.2 mg/m L MMC were placed in the conjunctival flap and scleral flap for 120 s respectively, and the ocular surface tissue was continuously washed with Ringer's lactate solution, while the control group was not treated with any drugs. The concentration of MMC in aqueous humor was measured by high performance liquid chromatography (HPLC) for 60 min after rinsing with Ringer lactate solution. The formation of scar and the number of functional filtration blebs were observed under optical microscope on the 1st and 14th day after operation. Results in conjunctival flap group and scleral flap group, the residual concentration of MMC in aqueous humor increased first and then decreased, reaching the peak 30 min after treatment. The residual concentrations of MMC in aqueous humor of conjunctival flap group and scleral flap group were 14.95 卤4.26 卤4.26 卤8.42)ng/m L ~ (30) min, respectively (27.26 卤6.33) 卤6.27)ng/m L ~ (60) min were 2.99 卤0.79 ~ 17.89 卤6.85)ng/m (P = 0.05), respectively, in conjunctival flap group and scleral flap group (P = 0.05). On the 14th day after operation, there were still effective filtering passageways in conjunctival flap group and scleral flap group, while in control group, the filtering passage was blocked by fibrous connective tissue. The number of functional blebs in each group was compared at 1: 7 and 14 days postoperatively (P < 0.05). Conclusion effective filtering passageway can be formed in rabbit trabeculectomy with conjunctival flap and scleral flap with concentration of 0.2 mg/m / L MMC, but the residual concentration of aqueous humor in the former is lower and the former is safer.
【作者单位】：唐山市眼科医院;天津医科大学眼科医院;
【基金】：天津市教委科技计划项目(20130133)
【分类号】：R779.6

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