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目的:观察晶状体摘除术时灌注液中加入低分子肝素(LMWH)对幼年新西兰白兔术后早期前房纤维性渗出的抑制作用,了解LMWH对血-房水屏障的影响。方法:幼年新西兰白兔20只,采用随机数字表法将其随机分成两组,即实验组和对照组,每组10只,实验组在Linger液中加入浓度6IU/mL的LMWH———Clexane(克赛),对照组采用单纯Linger液前房灌注,两组均行右眼透明晶状体囊外摘除,观察术后1,3,7,14d时两组兔前房纤维性渗出、角膜水肿和前房出血情况,并应用分子荧光标准曲线法测定上述时间点的房水荧光素含量。结果:实验组术后1,3d时前房纤维性渗出明显少于对照组,两组相比差异有统计学意义(P=0.001,0.010),7d时两组前房纤维渗出相比较差异没有统计学意义(P=0.078),14d时两组前房渗出均吸收;两组角膜水肿在术后1d和3d相比,差异无统计学意义(P=0.702,0.362),7d时角膜全部透明;术后各时间点两组兔均未观察到前房出血;实验组和对照组在术后各时间点房水荧光素含量差异均无统计学意义(P=0.569,0.152,0.696,0.703)。结论:6IU/mL的LMWH前房灌注可以安全有效地抑制术后眼内纤维蛋白渗出和炎症反应,无明显毒副作用,但并不具有对血-房水屏障直接的保护作用。
OBJECTIVE: To observe the inhibitory effect of low molecular weight heparin (LMWH) in early perfusion fluid of young New Zealand white rabbits on lens fibrinous exudation after lens ablation, and to understand the effect of LMWH on blood-aqueous barrier. Methods: Twenty young New Zealand white rabbits were randomly divided into two groups (experimental group and control group): random number table method, 10 rats in each group. In the experimental group, 6W / mL LMWH --- Clexane (Control group), a simple Linger fluid anterior chamber perfusion in both groups, both groups underwent extracapsular cataract extraction of the right eye with transparent lens. At 1, 3, 7 and 14 days after operation, the anterior chamber fibrinous exudation, corneal edema And anterior chamber hemorrhage, and the application of molecular fluorescence spectrophotometry determination of aqueous humor at the time point above the content of fluorescein. Results: The anterior chamber fibrinous exudation of the experimental group was significantly less than that of the control group on the 1st and 3rd day after operation (P = 0.001,0.010). Compared with the exudation of the anterior chamber fibers on the 7th day There was no significant difference between the two groups (P = 0.078). On the 14th day, there was no difference between the two groups (P = 0.702,0.362) The cornea was completely transparent; no anterior chamber hemorrhage was observed in the two groups at all time points after operation; there was no significant difference in the fluorescein levels between the experimental group and the control group at all time points after surgery (P = 0.569,0.152,0.696 , 0.703). CONCLUSION: 6IU / mL LMWH anterior chamber perfusion can safely and effectively inhibit intraocular fibrin exudation and inflammatory reaction without obvious side effects, but it has no direct protective effect on blood-aqueous barrier.