Ex-Press引流钉植入术在治疗新生血管性青光眼中的临床效果

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摘要目的探讨Ex-Press引流钉植入术在治疗新生血管性青光眼（NVG）中的临床效果。方法选取2015年1月～2019年6月桂林医学院附属医院收治的60 例NVG 患者作为研究对象进行回顾性分析，按照抗青光眼手术方法分为观察组（30 例）与对照组（30 例）。两组抗青光眼术前均先行玻璃体内注射康柏西普，待虹膜新生血管消退后，观察组行Ex-Press 房水引流钉植入术，对照组行复合小梁切除术，根据新生血管消退情况，术后2～3 周两组患者行全视网膜光凝术。比较两组患者抗青光眼术后3 d、1 周及1、3、6、12 个月的眼压，术后12 个月的视力，手术总有效率及并发症发生情况。结果两组术前眼压比较，差异无统计学意义（P＞0.05），两组术后3 d、术后1 周、术后1、3、6、12 个月的眼压均低于术前，且观察组术后各时间点眼压低于对照组，差异有统计学意义（P＜0.05）。两组术前最佳矫正视力（BCVA）比较，差异无统计学意义（P＞0.05）。术后12 个月观察组BCVA 优于对照组，差异有统计学意义（P＜0.05）。观察组并发症总发生率低于对照组，手术总有效率高于对照组，差异有统计学意义（P＜0.05）。结论康柏西普联合全视网膜光凝术，同时辅以Ex-Press 房水引流钉植入术治疗NVG，可有效降低患者的眼压，改善视力，效果显著，并发症较少。

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	黄海
	郑炜▲

关键词 ：新生血管性青光眼, Ex-Press引流钉, 小梁切除术, 康柏西普, 联合治疗

Abstract：Objective To investigate the clinical effect of Ex-Press drainage nail implantation in the treatment of neovascularization glaucoma(NVG).Methods A total of 60 patients with NVG admitted to the Affiliated Hospital of Guilin Medical College from January 2015 to June 2019 were selected as the research objects for retrospective analysis and divided into the observation group(30 cases)and the control group(30 cases)according to anti-glaucoma surgery methods.Before anti-glaucoma surgery,both groups received intravitreous injection of Conbercept.After iris neovascularization subsided,the observation group received Ex-Press aqueous chamber drainage screw implantation,while the control group received compound trabeculectomy.According to the regression of neovascularization,total retinal photocoagulation was performed 2-3 weeks after surgery in both groups.The intraocular pressure at 3 d,1 week and 1,3,6,12 months after anti-glaucoma surgery,the visual acuity at 12 months after surgery,the total effective rate of surgery and the incidence of complications were compared between two groups.Results There was no significant difference in intraocular pressure between the two groups before operation(P＞0.05).The intraocular pressures at 3 d,1 week,1,3,6 and 12 months after surgery in both groups were lower than those before surgery,and the intraocular pressures in the observation group were lower than those in the control group at each time point after surgery,the differences were statistically significant(P＜0.05).There was no significant difference in best corrected visual acuity(BCVA)between the two groups(P＞0.05).At 12 months after operation,BCVA in the observation group was better than that in the control group,and the difference was statistically significant(P＜0.05).The total incidence of complications in the observation group was lower than that in the control group,and the total operative effective rate was higher than that in the control group,with statistical significances(P＜0.05).Conclusion Conbercept combined with total retinal photocoagulation combined with Ex-Press aqueous chamber drainage nail implantation in the treatment of NVG has been shown to effectively reduce intraocular pressure and improve visual acuity,with significant results and fewer complications.

Key words： Neovascular glaucoma Ex-Press drainage nail Trabeculectomy Conbercept Combined therapy

基金资助:广西壮族自治区卫生健康委员会自筹经费科研课题（Z20200057）

通讯作者: 郑炜（1983-），女，黑龙江五常人，硕士，主治医师，研究方向：内分泌代谢疾病及高等教育

作者简介: 黄海（1982-），男，广西桂林人，主治医师，研究方向：青光眼、眼底病

引用本文:

黄海；郑炜▲. Ex-Press引流钉植入术在治疗新生血管性青光眼中的临床效果[J]. 中国当代医药, 2021, 28(17): 133-136.
HUANG Hai；ZHENG Wei▲. Clinical effect of Ex-Press drainage nail implantation in the treatment of neovascularization glaucoma. 中国当代医药, 2021, 28(17): 133-136.

链接本文:

http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I17/133

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