摘要
目的 :探讨视网膜静脉微穿刺介入治疗视网膜静脉阻塞的技术方法、并发症及其处理措施 ,观察疗效。方法 :利用自行研制的眼超显微手术系统 ,实现活体视网膜静脉微穿刺 ;采用光动力学方法建立视网膜静脉阻塞动物模型 ,在阻塞的视网膜静脉内注入溶栓剂 t PA,观察溶栓效果和术中、术后视网膜及其血管改变。结果 :超显微手术系统能够实现稳定的视网膜血管微穿刺 ,并向血管内持续注药。在视网膜静脉血栓形成早期 ,该方法能使血栓迅速溶解脱落 ,疏通血管 ,恢复静脉血流。病理结果显示 ,视网膜静脉微穿刺介入溶栓后 ,不但能够逆转视网膜静脉阻塞的病理改变 ,而且对视网膜及其血管无明显损伤。结论 :视网膜静脉微穿刺 ,注入溶栓剂可能为视网膜静脉阻塞早期治疗提供一条新途径。该技术的不断完善 ,不仅可望用于视网膜静脉阻塞的临床治疗 ,而且还可用于清除视网膜下出血、视网膜组织活检。
Objective: To develop a method for treatment of retinal vein occlusion by infusing thrombolytic agents into the retinal vein with micropuncture of the retinal vein. Materials: Twenty four miniature pigs of experimental retinal vein occlusion were divided into three groups: (1) non operation, (2) sterile water was infused into obstructed retinal vein, (3) tissue type plasminogen activator was infused into obstructed retinal vein. Methods: we designed an ultramicrosurgical system that used the control of a six degree of freedom micromanipulator and an electromagnetic holder to direct a micropipette tip to puncture retinal vein. Low dose tissue type plasminogen activator or sterile water was then infused into the retinal vein via a controlled microperfusion pump to treat experimental retinal vein occlusion. Fluorescein angiographies and histological sections were taken to correlate the morphological alterations with clinical observations. Results: The thrombus was lysed by tissue type plasminogen activator and then dropped following the blood flow. After micropipette was drawn out from the vessel, no bleeding and no leakage of the infused drug was found from the site of puncture. But sterile water could not flush the clot away. When the thrombus did not drop and the infusion liquid flow back to the distal retinal vein for a long time, exudative retinal detachment would happen. Conclusions: This study shows that it may be a new technique to infuse thrombolytic agents into retinal vein for treatment of retinal vein occlusion.\;
出处
《海军总医院学报》
2001年第2期84-88,共5页
Journal of Naval General Hospital of PLA
基金
国家自然科学基金资助 项目(39870798)
关键词
视网膜静脉阻塞
溶栓疗法
微操作
组织型纤溶酶原激活剂
Rtinal vein occlusion Thrombolytic therapy Micromanipulation Tissue type plasminogen activator
