透明質酸钠、甲波尼龙聯合用于小梁切除术的临床研究

A randomized, prospective study on the use of Sodium Hyaluronate combined with Methylprednisolone in trabeculectomy

目的 評價透明質酸鈉、甲潑尼龍聯合用于青光眼濾過手術的臨床療效及應用價值。方法 將53例64眼晚期閉角型青光眼随機分為兩組(實驗組、對照組),每組32只眼。患者年齡40-70歲,均為初次手術。實驗組術中應用甲潑尼龍1mg棉片濕敷5分鐘,縫合鞏膜辦前將透明質酸鈉0.05ml注射于濾過道。定期隨訪20-31個月。结果 術后兩組間經t檢驗和X^2檢驗分析。眼壓差异具顯著性(P<0.05)。2年后實驗組手術成功率為87.5％,對照組僅為53.13％,差异具顯著性(P<0.05)。結論 經對比觀察研究,本方法安全、簡單,可明顯提高手術成功率,减少手術并發症,兩種藥物在濾過手術中具推廣應用前景。

Objective To evaluate whether Sodium Hyaluro nate combined with Methylprednisolone can improve effect of trabeculectomy. Methods In a randomized controlled clinical trial, 53 patients (64 eyes) with angle - closure glaucoma of advanted stage were divided into two groups (H&M group and control group) with 32 eyes in each. The patients ranged from 40 to 70 in age and for them all, it was the first operative treatment for their disease. In H&M group the flaps were covered with 1 mg methylprednisolone dressing for 5 mins during operation and 0.05ml sodium hyaluronate was injected into filtering channel just before scleral flap was closed. The follow - up period lasted from 20 to 31 months and data were analyzed with t test and X2 test. Results The intraocular tension of the two groups was significantly different (P< 0. 05) .2 years after operation,the success rate was 87.5% in H&M group, and 53.13% in control group, the difference being significant (P< 0.05). Conclusion The study indicates that our method is safe and simple which can remarkably increase the success probability of trabeculectomy and reduce the complications. There is a bright prospect for H&M to substitute other medicines in antiglaucoma filtering surgery.