单纯小梁切除与复合性小梁切除治疗青光眼的临床效果观察

Clinical observation of trabeculectomy and compound trabeculectomy for glaucoma

目的观察单纯小梁切除与复合性小梁切除治疗青光眼的临床效果差异。方法将临床确诊为原发性青光眼来我院眼科行手术治疗的住院患者分为单纯小梁切除组和复合性小梁切除组,比较两组患眼的眼压、浅前房形成率、治疗后滤过泡形成情况和总体有效率的差异。结果两组患眼手术前、手术后第5天的眼压差异无统计学意义(P>0.05);而1个月后随访时,两组之间的差异具有统计学意义(P<0.01)。单纯小梁切除术组的浅前房形成率要显著高于复合式小梁切除术组(P<0.05)。单纯小梁切除术组非功能性滤过泡(Ⅲ、IV级)形成率为35.09%,复合式小梁切除术组非功能性滤过泡形成率8.47%,两组之间的差异具有统计学意义(P<0.05)。采用单纯小梁切除术的患者的总体有效率为77.19%,采用复合式小梁切除术的患者的总体有效率为96.61%,两组之间的差异有统计学意义(P<0.01)。结论复合式小梁切除术有效减少术后浅前房的发生,在控制远期眼压和功能性滤过泡形成方面疗效显著,提高了手术成功率,值得临床推广。

Objetive To observe the clinical effect of trabeculectomy and compound trabeculectomy in the treatment of glaucoma. Methods The patients with primary glaucoma were divided into two groups： trabeculectomy group and compound trabeculcctomy group. The intraocular pressure, shallow anterior chamber formation rate, the filtration bubble formation and the overall efficiency difference were recorded and analyzed.Results There was no significant difference in the intraocular pressure between the two groups before and 5 day after operation （P〉 0.05）. The difference between the two groups at 1 month after the surgery was statistically significant （P 〈0.01） The The shallow anterior chamber formation rate in the trabeeuleetomy group was significantly higher than that in the compound trabeeulectomy group （P 〈0.05）. The formation rate of nonfunctional bleb （m, IV） was 35.09% in the trabeeuleetomy group and 8.47% in the composite trabeculeetomy group. The difference between the two groups was statistically significant （P〈O.05）. The overall effective rate was 77.19% in patients with simple trabeculectomy, wiht 96.61% in patients with compound trabeculectomy, and the difference was statistically significant （P 〈0.01）. Conclusion Compound trabeculectomy can effectively reduce the occurrence of postoperative shallow anterior chamber, and it has significant curative effect in controlling long - term intraocular pressure and functional bleb formation. It can improve the success rate of operation and deserve clinical promotion.