球筋膜下麻醉的复合式小梁切除术治疗高眼压下青光眼的临床观察

Clinical Observation of Combined Trabeculectomy to Treat Glaucoma Under Sub-Tenon's Anesthesia with Persistent High Intraocular Pressure

目的探讨球筋膜下麻醉进行复合式小梁切除术治疗高眼压下的青光眼临床效果。方法我院连续收入院的50例60眼青光眼患者分为观察组和对照组。观察组25眼:球筋膜下麻醉进行复合式小梁切除术治疗青光眼;对照组35眼:球后麻醉小梁切除术治疗青光眼,观察患者合作度,眼压。结果球筋膜下麻醉组有89.2%的合作度,球后麻醉组有88.2%的患者合作比较好或非常好合作度,两组比较差异无统计学意义(P>0.05)。两组术前眼压相似差异无统计学意义(P>0.05),术后6个月眼压:观察组(11.42±5.16)mmHg,对照组(14.12±3.24)mmHg,差异有统计学意义(P<0.05)。眼压≤21mmHg为标准,观察组的完全成功率为96%,条件成功率为100%。对照组完全成功率为74.3%,条件成功率为80%,两组比较差异有统计学意义(P<0.05)。结论持续高眼压状态下的青光眼行球筋膜下麻醉的复合式小梁切除术是安全和有效的。在用药24～48h,仍然持续高眼压状态的病例应尽早进行手术治疗。

Objective To investigate the clinical effect of combined trabeculetomy to treat glaucoma under sub-Tenon,s anesthesia.Methods 50 consecutive patients who received the glaucoma surgery patient were received sub-Tenon,s anesthesia（observe group of 25 cases）or retrobulbar anesthesiar（control group of 35 cases）before the surgery.The patient were asked to grade their cooperation.Result Intraocular pressure（IOP）before treatment in both groups their similar（P0.05）.Mean IOP 6 months after treatment was（11.42±5.16）mmHg in observe group and（14.12±3.24）mmHg in（control group which is significantly different（P0.05）.The success rate（IOP lower than 21mmHg）was 96% in eyes with li sub-Tenon＇s anesthesia versus 74.3% in eyes with retrobulbar anesthesiar which was not significantly different（P0.05）.Conclusion Combined trabeculectomy is efective and safe for glaucoma with persistent high intraocular pressure.