针刺分离联合氟尿嘧啶治疗青光眼小梁切除术后无功能滤过泡疗效观察

Effect of needle revision combined with subconjunctival injection with fluorouracil on the nonfunctional filtering bleb after trabeculectomy in patients with glaucoma

目的探讨针刺分离联合氟尿嘧啶结膜下注射治疗青光眼术后无功能滤过泡的临床效果。方法选择2015年1月至2016年1月哈尔滨焦视眼科医院收治的青光眼术后眼部无功能滤过泡患者50例(50只眼),根据治疗方法分为对照组24例和观察组26例。对照组患者给予针刺分离治疗,观察组患者给予针刺分离联合氟尿嘧啶结膜下注射治疗。随访3个月,比较2组患者的治疗效果。结果治疗前2组患者眼压比较差异无统计学意义(P>0.05);治疗后1、3个月,2组患者眼压均显著低于治疗前(P<0.05),且观察组患者眼压显著低于对照组(P<0.05)。对照组和观察组患者功能性滤过泡形成率分别为45.83%(11/24)和73.08%(19/26),观察组患者功能性滤过泡形成率显著高于对照组(P<0.05)。对照组和观察组患者治疗完全成功率分别为41.67%(10/24)和73.08%(19/26),观察组患者完全成功率显著高于对照组(P<0.05)。对照组和观察组患者并发症发生率分别为20.83%(5/24)和34.62%(9/26),2组患者并发症发生率比较差异无统计学意义(P>0.05)。结论针刺分离联合氟尿嘧啶结膜下注射治疗青光眼小梁切除术后无功能滤过泡安全有效,可显著降低眼压,促进功能性滤过泡形成。

Objective To study the clinical effect of needle revision combined with subconjunctival injection with flu- orouraeil on the nonfunctional filtering bleb after trabeeulectomy in patients with glaucoma. Methods A total of 50 patients （50 eyes） with nonfunctional filtering bleb after trabeeulectomy were selected in Harbin Jiaoshi Eye Hospital from January 2015 to January 20 l 6. All the patients were divided into control group （ n = 24 ） and observation group （ n = 26 ）. The patients in control group were treated with needle revision, and the patients in observation group were treated with needle revision and sub- conjunctival injection with fluorouracil. The patients were followed up for three months, and the effect was compared between the two groups. Results There was no significant difference in the intraocular pressure between the two groups before treat- ment（P 〉 0.05）. The intraocular pressure at the time points of one month and three months after treatment was significantly lower than that before treatment in the two groups （ P 〈 0.05 ）, and the intraoeular pressure in observation group was significant- ly lower than that in control group（ P 〈0.05）. The formation rate of functional filtering bleb in control group and observation group was 45.83% （11/24） and 73.08% （19/26） respectively, the formation rate of functional filtering bleb in observation group was significantly higher than that in control group（ P 〈 0.05 ）. The complete success rate in control group and observation group was 41.67% （10/24） and 73.08% （19/26） respectively, the complete success rate in observation group was signifi- cantly higher than that in control group （ P 〈 0.05 ）. The incidence rate of complications in control group and observation group was 20.83% （5/24） and 34.62% （9/26）, there was no significant difference in the incidence rate of complications between the two groups （P 〉 0.05）. Conclusion Needle revision combined with subconjunctival injection with fluorouracil on the non- functional fihering bleb after trabeculectomy is safe and effective,which can significantly reduce intraocular pressure and pro- mote the formation of functional filtering bleb.