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目的 探讨眼球按摩对青光眼滤过术后改善滤过功能的评价标准。方法 通过对56例98眼小梁切除术后,需要进行眼球按摩的患者,随机分成上睑组29例51眼和下睑组27例47眼,采用两种不同方式的眼球按摩手法,经过测量眼压,观察前房、滤过泡(Seidel试验)、瞳孔等进行临床分析。结果 两种按摩手法均能有效地改善青光眼滤过术后的滤过功能,上睑组96.08％有效,3.92％无效;滤过泡Ⅰ型29眼,Ⅱ型20眼,Ⅲ型、Ⅳ型各1眼;下睑组95.74％有效,4.26％无效,滤过泡Ⅰ型26眼,Ⅱ型19眼,Ⅲ2眼,并有少量并发症存在。两组疗效无显著差异(P>0.05)。结论 青光眼滤过术后初期,及时发现滤过功能减退的征象,并及时准确地进行持续辅助治疗,如眼球按摩,是其疗效的关键时期。手指按摩以眼压、前房、滤过泡的变化作为疗效评价标准,是调整按摩指力,次数及时间的依据。
Objective To investigate the evaluation criteria of eye massage for improving filtration function after glaucoma filtration surgery. Methods 56 cases of 98 trabeculectomy, the need for ocular massage were randomly divided into upper eyelid group 29 cases 51 eyes and lower eyelid group 27 cases 47 eyes, using two different ways of eye massage, after measurement Intraocular pressure, observation of anterior chamber, filtration bleb (Seidel test), pupils and other clinical analysis. Results Both massage methods could effectively improve the filtering function after glaucoma filtration. The upper eyelid group was 96.08% effective and 3.92% was ineffective. The bleb type I was 29, type Ⅱ 20, type Ⅲ and type Ⅳ 1 eyes. The lower eyelid group was 95.74% effective, 4.26% was ineffective, bleb 26 cases, type Ⅱ 19 eyes and Ⅲ 2 eyes, with a few complications. There was no significant difference between the two groups (P> 0.05). Conclusions The early stage of glaucoma filtration, timely detection of signs of filtration dysfunction, and timely and accurate continuous adjuvant therapy, such as eye massage, is the key period of its efficacy. Finger massage to intraocular pressure, anterior chamber, bleb filtration changes as a curative effect evaluation criteria, is to adjust the massaging force, frequency and time basis.