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目的:研究人脐带静脉管(HUV)植入联合应用丝裂霉素C(MMC)在非穿透性小梁手术(NPTS)中应用的临床效果。方法:选取中、晚期原发性开角型青光眼病例32例(46眼)。患者分为两组:HUV+MMC组(n=25),透明质酸生物胶(SKGEL)+MMC组(n=21);行非穿透性小梁手术,HUV+MMC组将HUV置于巩膜床内,SKGEL+MMC组将SKGEL缝合固定于巩膜床上。术后分别于1,2,4wk;2,6,12mo裂隙灯下观察术口愈合情况、滤过泡情况、前房炎症反应、前房深度、有无出血等。测量眼压、最佳矫正视力,计算手术成功率。结果:HUA+MMC组的术后眼压平均在16mmHg,HUA+MMC组与SKGEL+MMC组在术后1,2,4wk;2,6,12mo时P>0.05,差异无显著性;功能性滤过泡术后1wk～12mo时HUA+MMC组与SKGEL+MMC组比较无显著性差异(P>0.05),末次随访HUA+MMC组成功(完全成功和条件成功)21眼,成功率84%;SKGEL+MMC组成功18眼,成功率86%。两组末次随访手术成功率比较无显著性差异(P>0.05)。结论:HUV联合MMC在NPFS中对术眼有明显而稳定的降压作用,大大提高了NPTS的手术成功率。脐带静脉管取材方便,抗原性低,有良好的组织相容性,眼局部反应轻,无毒副作用,且与SKGEL植入物相比,价格便宜,是理想的NPTS中的植入物。
Objective: To investigate the clinical effect of human umbilical vein catheter (HUV) implantation combined with mitomycin C (MMC) in non-penetrating trabecular surgery (NPTS). Methods: Thirty-two cases (46 eyes) of middle and advanced primary open-angle glaucoma were selected. The patients were divided into two groups: HUV + MMC group (n = 25), SKGEL + MMC group (n = 21) Sclera bed, SKGEL + MMC group SKGEL suture fixed in the scleral bed. Postoperative 1,2, 4wk; 2,6,12mo slit lamp under the observation of surgical healing, filtration bleb conditions, anterior chamber inflammation, anterior chamber depth, with or without bleeding. Measuring intraocular pressure, best corrected visual acuity, calculate the success rate of surgery. Results: The mean intraocular pressure (IOP) in HUA + MMC group was 16mmHg, while there was no significant difference between HUA + MMC group and SKGEL + MMC group at 1, 2, 4wk and 2, 6, There was no significant difference between HUA + MMC group and SKGEL + MMC group at 1wk ~ 12mo after filtering blebs (P> 0.05). At the last follow-up, 21 eyes were successfully completed (successfully and successfully) with a success rate of 84% ; SKGEL + MMC group of 18 successful, the success rate of 86%. There was no significant difference in the success rate of the two follow-up visits (P> 0.05). Conclusion: HUV combined with MMC has obvious and stable antihypertensive effects on eyes in NPFS, which greatly improves the success rate of NPTS. Umbilical vein tubes are easy to obtain, have low antigenicity, good histocompatibility, light eye site reactions, no toxic or side effects, and are inexpensive compared to SKGEL implants, making them ideal for implants in NPTS.