丝裂霉素在难治性青光眼滤过术中应用的疗效及护理分析

Effect and nursing analysis of mitomycin in the treatment of refractory glaucoma trabeculectomy

目的探讨丝裂霉素在难治性青光眼滤过术中的治疗效果及护理方法。方法选取难治性青光眼患者84例(共100眼),将患者随机均分为治疗组与对照组,均采用常规的小切除术。治疗组在完成结膜瓣和板层巩膜瓣后用浸含丝裂霉素C棉片置于巩膜瓣下以及瓣上2～3 min,去除棉片,生理盐水冲洗;对照组只实施常规的小切除术治疗。对2组患者均给予精心观察与护理,对比2组术后滤过泡情况、眼压控制情况。结果治疗组功能性滤过泡为90.38%,高于对照组的56.25%,2组比较差异有统计学意义(P<0.05);治疗组眼压控制完全成功率为94.23%,对照组为62.50%,2组比较差异有统计学意义(P<0.01)。结论应用丝裂霉素可有效防止术后滤过泡瘢痕组织形成,配合优质的护理,是治疗难治性青光眼的有效方法。

Objective To explore the effect of mitomycin on the treatment of refractory glaucoma trabeculectomy and related nursing methods.Methods 84 refractory glaucoma patients（100 eyes） were selected and randomly divided into the treatment group and the control group,both groups were treated with conventional trabeculectomy.For the treatment group,after finishing conjunctival flap and lamellar scleral flap,the cotton slices with mitomycin C were placed under and above scleral flap for 2～3 minutes,and then the cotton slices were removed and the position was washed with physiological saline.Both groups were treated with careful observation and nursing.Filtering bled situation and intraocular pressure situation were compared between two groups.Results Functional filtering bleb in the treatment group was 90.38%, which was higher than 56.25% in the control group,and there was significant difference between two groups（P＆lt;0.05）.The success rate of intraocular pressure control in the treatment group was 94.23%,which was higher than 62.50% in the control group,and there was significant difference between two groups（P＆lt;0.01）.Conclusion Application of mitomycin can effectively prevent the occurrence of postoperative cicatrical tissue of filtering bleb.Combined with good nursing measures,mitomycin is regarded as an effective treatment for refractory glaucoma.