玻璃体切割术联合组织型纤溶酶原激活物和速避凝治疗兔细菌性眼内炎所致纤维蛋白渗出

Vitrectomy combined with tissue plasminogen activator and fraxiparine for fibrin exudation caused by bacterial endophthalmitis in rabbits

目的探讨玻璃体切割联合组织型纤溶酶原激活物(r-tPA)和速避凝治疗细菌性眼内炎的效果。方法将40只青紫兰家兔随机分为实验组和对照组,每组各20只。向兔左眼玻璃体腔内注射105个/ml表皮葡萄球菌0.1ml,经过8～14h后,所有动物均接受玻璃体切割手术。手术中在实验组使用的平衡盐灌注液内加入速避凝,其终浓度为6IU/ml;手术后运用裂隙灯和间接检眼镜观察眼内纤维蛋白渗出的程度。若实验组手术后1、3、7、14、21d眼内存在纤维渗出,从手术后第1天开始向玻璃体腔内注射125mg/ml的r-tPA0.1ml。结果手术后实验组兔眼瞳孔区及玻璃体腔内纤维渗出较对照组显著减轻。结论玻璃体切割术联合r-tPA和速避凝的应用,能减轻兔细菌性眼内炎的纤维化程度,改善预后。

Objective To observe the therapeutic effects of vitrectomy combined with tissue plasminogen activator（r-tPA） and fraxiparine on bacterial endophthalmitis. Methods Forty pigmented rabbits were randomly divided into experimental and control group with 20 rabbits in each. The left eyes underwent intra vitreous injection with 10^5/ml bacteria of staphylococcus epidermidis 0.1 ml. After 8-14 hours, vitrectomy was performed on all of the animals. Fraxiparine with the final concentration of 6 IU/ml was only added to balanced salt solution in the experimental group during the operation, and the extend of intraocular fibrin exudation was observed by slit lamp and indirect ophthalmoscope after the operation. If the exudation occurred on the 1st, 3rd, 7th, 14th and 21st day postoperatively, 125 mg/ml r tPA 0.1 ml should be injected into vitreous from the 1st day after operation on. Results Fibrin exudation in the pupil area and vitreous body was much less in experimental group than that in the control group after the surgery. Conclusion vitrectomy combined with r-tPA and fraxiparine may alleviate the extent of fibrosis in bacterial endophthalmitis and improve the prognosis.