低分子量肝素——速避凝预防玻璃体切除术后眼内纤维蛋白渗出

Low molecular weight heparin (fraxiparine)for prevention of experimental postvitrectomy intraocular fibrin

目的观察低分子量肝素——速避凝对兔眼玻璃体切除术后眼内纤维蛋白渗出的预防效果。方法青紫蓝兔１４只随机分为两组，均进行标准的晶体粉碎切割及中央玻璃体切除，盲法给予灌注液，对照组为平衡盐液，实验组为平衡盐液中加入速避凝，浓度为６Ｕ／ｍｌ，观察术后眼内纤维蛋白渗出及术中、术后眼内出血情况。结果实验组术后第一至第三天眼内纤维蛋白渗出均明显轻于对照组（Ｐ＜０．０１）；眼内纤维蛋白渗出平均清除时间也较对照组短（Ｐ＝０．００１），两组术中及术后眼内出血情况无显著差异。结论低分子量肝素——速避凝可有效地预防玻璃体切除后眼内纤维蛋白的形成，并且不增加眼内出血的危险性。

Purpose To determine the efficacy of a low molecular weight heparin(fraxiparine)administered in the infusion fluid to prevent postoperative fibrin formation in a rabbit lensectomy and vitrectomy model. Methods Fourteen adult pigmented rabbits were randomly assigned into two groups.Standard fragmatome lensectomies and core vitrectomies were performed prospectively in a masked fashion on control eyes with balanced salt infusion and on experimental eyes treated with fraxiparine/ml 6U in the infusate.Intraoperative bleeding was graded in a masked fashion by the surgeon.The amounts of fibrin and hemorrhage were graded in a masked fashion on postoperative days 1 through 7. Results The mean grde of fibrin in the eyes treated with fraxiparine was lower than that in the control eyes(P<0.01)on postoperative days 1 through 3 respectively.Also,the average days to clear the fibrin in the eyes treated with fraxiparine was shorter than that in the control eyes(P=0.001).No statistically significant differences in the degree of intraoperative or postoperative hemorrhage were noted between the two groups. Conclusion Low molecular weight heparin(fraxiparine)is an effetive inhibitor of postoperative fibrin formation in a rabbit model and is not associated with an increased risk of intraoperative or postopertive bleeding at the tested dose.