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《广州医药》编辑部
目的 比较改良LIFT术(经括约肌间瘘管结扎术)和常规LIFT术治疗单纯性经括约肌型肛瘘的临床疗效。方法 2013年1月—2014年12月,86例单纯性经括约肌型肛瘘患者,随机分成A组和B组,分别接受改良LIFT 术(A组)与常规LIFT术(B组)42例和44例。通过比较两组病例的手术时间、术后疼痛VAS评分、伤口愈合时间、住院时间及治愈率评估两种手术方法的临床疗效。所有随访患者于术后第3个月均测定肛门直肠压力和进行盆底肌电图检查以评估肛门功能。结果 所有患者均获得随访3个月~26个月,平均(8.73±7.15)月。两组患者的手术时间、术后24 h VAS疼痛评分和住院时间比较,差异无统计学意义(P>0.05)。两组患者的伤口愈合时间比较,差异无统计学意义(P>0.05)。但A组治愈率为88.10%,高于B组治愈率63.63%,差异有统计学意义(P<0.05)。两组患者术前和术后3个月的肛门直肠压力无变化,差异无统计学意义(P>0.05);两组患者术前和术后3个月的内、外括约肌和耻骨直肠肌MUP 平均时限比较,差异均无统计学意义(P>0.05)。结论 改良LIFT术较常规LIFT术提高治愈率,是治疗单纯性经括约肌型肛瘘的有效术式。
目的 基于最佳矫正视力(BCVA)、角膜水肿程度对比改良与常规小梁切除术治疗急性闭角型青光眼(AACG)的疗效。方法 回顾性收集2021年12月—2023年6月期间信阳爱尔眼科医院收治的112例AACG患者作为研究对象,依据1∶1匹配原则,将接受常规小梁切除术的56例患者作为对照组,接受改良小梁切除术的56例患者作为观察组,统计两组围术期BCVA、眼压、术后浅前房形成状况、角膜水肿程度以及并发症状况。结果 术后3个月,观察组视力为(0.63±0.04)logMAR,高于对照组(0.50±0.03)logMAR,眼压为(16.22±2.28)mmHg,低于对照组(19.95±2.31)mmHg(t=19.457、8.600,均P<0.05);观察组浅前房发生率为8.93%,低于对照组的26.79%(χ 2 =6.087,P=0.014);观察组角膜水肿状况优于对照组(Z=2.737,P=0.006);观察组脉络膜脱离率、滤道阻塞率、前房积血率、虹膜炎症率依次为1.79%、5.36%、16.07%、10.71%,均低于对照组17.86%、23.21%、32.14%、35.71%(χ 2 =8.166、7.292、3.953、9.818,均P<0.05)。结论 较常规小梁切除术,改良小梁切除术治疗AACG患者,有助于改善视力、降低眼压、减轻角膜水肿、减少浅前房发生,且安全性较高。
Objective To compare the efficacy of modified and conventional trabeculectomy in the treatment of acute angle-closure glaucoma(AACG)based on best-corrected visual acuity(BCVA)and degree of corneal edema.Methods A total of 112 patients with AACG admitted to the hospital during December 2021 to June 2023 were retrospectively selected as study objects.According to the 1∶1 matching principle,56 patients receiving conventional trabeculectomy were selected as control group,and 56 patients receiving modified trabeculectomy were selected as observation group.Perioperative BCVA,intraocular pressure,postoperative shallow anterior chamber formation,degree of corneal edema and complications were analyzed.Results At three months postoperatively,visual acuity in the observation group was(0.63±0.04)logMAR,which was higher than that in the control group(0.50±0.03)logMAR,and intraocular pressure was(16.22±2.28)mmHg,which was lower than that in the control group(19.95±2.31)mmHg(t=19.457,8.600,P<0.05);the incidence of shallow anterior chamber in the observation group was 8.93%,which was lower than that of the control group(26.79%)(χ 2 =6.087,P=0.014);the corneal edema status in the observation group was better than that of the control group(Z=2.737,P=0.006);the rates of choroidal detachment,filtering channel obstruction,hyphema,and iris inflammation in the observation group were 1.79%,5.36%,16.07%,and 10.71%,respectively,which were lower than those of the control group(17.86%,23.21%,32.14%,and 35.71%)(χ 2 =8.166,7.292,3.953,and 9.818,P<0.05).Conclusions Compared with conventional trabeculectomy,modified trabeculectomy can improve visual acuity,reduce intraocular pressure,relieve corneal edema,and reduce the occurrence of shallow anterior chamber in patients with AACG,with higher safety.
目的 针对目前常规使用的玻璃体腔注射针头容易引起注射后小鼠眼内出血和损伤晶状体的缺陷,本研究采用直径仅0.08 mm的玻璃毛细管作为实验用小鼠眼内注射针头进行玻璃体腔注射,并评估其安全性和可行性。方法 选取12只6-8周的C57BL/6J雄性小鼠,左眼注射磷酸盐缓冲液为实验组,右眼不做特殊处理为对照组。6只小鼠玻璃体腔注射后立即腹腔注射伊文思蓝,检测视网膜血管渗漏情况;另外6只小鼠玻璃体腔注射后24 h处死,视网膜铺片免疫荧光染色小胶质细胞特异性抗体抗离子钙接头蛋白1,分析小胶质细胞的形态变化。结果 实验组和对照组血管与周围荧光强度比值分别为(4.45±0.30)和(4.51±0.24),小胶质细胞数量分别为(131.00±5.38)个/mm2 和(133.00±5.99)个/mm2 ,小胶质细胞胞体面积分别为34.02(27.82,40.54)μm2 和34.70(26.09,40.54)μm2 ,小胶质细胞分支长度分别为198.80(171.30,258.80)μm和223.30(178.20,278.30)μm,两组相比差异均无统计学意义(均P>0.05)。结论 经改良的玻璃毛细管直径更细,损伤更小,可以替代传统的注射针头,可作为实验用小鼠眼内注射针头进行玻璃体腔注射。
Objective To assess the safety and feasibility of employing an enhanced glass capillary,with a diameter of 0.08 mm,as an intraocular needle for intravitreal injections in experimental mice eyes.Methods Twelve male C57BL/6J mice,aged 6-8 weeks,were utilized in this investigation.Phosphate buffered saline(PBS)was administered via intravitreal injection into the left eye of each mouse(experimental group),while the right eye received no special treatment(control group).Six mice received an intraperitoneal injection of Evans blue immediately following intravitreal injection to detect retinal vessel leakage.The remaining six mice were euthanized 24 hours after intravitreal injection,and the retinas were subjected to immunofluorescence staining using a microglia-specific antibody to analyze morphological changes in microglia.Results In both the experimental and control groups,the ratio of vascular to peripheral fluorescence intensity was(4.45±0.30)and(4.51±0.24),respectively.The number of microglia was(131.00±5.38)/mm2 and(133.00±5.99)/mm2 ,the cell body area of microglia was 34.02(27.82,40.54)μm2 and 34.70(26.09,40.54)μm2 ,and the branch length of microglia was 198.80(171.30,258.80)μm and 223.30(178.20,278.30)μm,respectively.There were no statistically differences observed in any of the above indicators between the two groups(all P>0.05).Conclusions The use of this glass capillary,characterized by a narrower diameter,reduces tissue damage,demonstrates its potential to replace traditional injection needles for performing intravitreal injections in experimental mice.