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目的 :探讨青光眼滤过手术中抗代谢药物促滤泡形成的作用。方法 :对 45 0例难治性青光眼患者实施小梁切除术 ,手术分为 3组 ,A组采用无暴露线结的巩膜瓣缝线可拆除技术 ,并在术中使用沾有 0 5mg/ml的丝裂霉素C(MMC)液棉片处理巩膜切口 ,B组和C组实施常规小梁切除术 ,术后B组结膜下注射 5 Fu ,C组不用抗代谢药物 ,仅做常规处理。结果 :术后 3 88只眼随访 6～ 3 0个月 ,A组的成功率从 86%降至 65 % ,B组从 83 %降至60 % ,C组 6～ 2 4个月的成功率从 5 8%降至 2 6% ,明显低于使用抗代谢药物组 (P <0 .0 5 ) ,A组的术后并发症较B组少。结论 :抗代谢药物 5 Fu和MMC均能明显抑制滤过区瘢痕形成 ,提高难治性青光眼的手术成功率 ,MMC的效果较 5 Fu更好 ,并发症也较少
Objective: To investigate the role of antimetabolites in promoting the formation of follicles in glaucoma filtration surgery. Methods: Forty-five patients with refractory glaucoma underwent trabeculectomy. The operation was divided into three groups. Group A was treated with scleral suture removal without exposure to knot thread, and was stained with 0 5 mg / ml Of mitomycin C (MMC) fluid cotton membrane sclerectomy, B and C group conventional trabeculectomy, after subconjunctival injection group B 5 Fu, C group without anti-metabolism drugs, only conventional treatment. Results: A total of 388 eyes were followed up for 6 to 30 months. The success rate of group A decreased from 86% to 65%, while that of group B decreased from 83% to 60%. The success rate of group C from 6 to 24 months From 58% to 26%, which was significantly lower than that of the antimetabolites group (P <0.05). The postoperative complications of group A were less than those of group B. Conclusion: Both anti-metabolic drugs 5 Fu and MMC can significantly inhibit the scar formation in filtration area and improve the surgical success rate in refractory glaucoma. The effect of MMC is better than that of 5 Fu and the complication is less