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。

AIM:To investigate the inhibition of LMWH (low-molecule-weight heparin) added in irrigating solution to fibrin exudation in anterior chamber after the surgery of ECCE (extra-capsular cataract extraction) for infant New Zealand rabbits, and the influence on the blood-aqueous barrier. METHODS:Twenty infant rabbits were randomly divided into trial group and control group. ECCE was performed on the right eyes of all rabbits in the two groups, and Linger solution was used as irrigating solution during the surgery. Differently, LMWH——Clexane was added into the irrigating solution in trial group, and the concentration was 6IU/mL, while in control group, only Linger solution was used. Fibrin exudation in anterior chamber, corneal edema and hemorrhage in anterior chamber were observed at the 1st, 3rd, 7th and 14th day after surgery, and the fluorescence concentration in aqueous humor at above time spots was tested. RESULTS:At the 1stand 3rd day after surgery, fibrin exudation in trial group was obviously weaker than in control group, and the difference was significant (P=0.001, 0.010). At the 7th day after surgery, there was no significant difference between the two groups, and no fibrin exudation was observed at the 14th day after surgery in both groups. Corneal edema was observed in both groups at the 1st and 3rd day, and the difference was not significant (P=0.702 and 0.362). Corneal edema disappeared on the 7th day in both groups. No hemorrhage was found in two groups at any time. The fluorescence concentration in aqueous humor at any time spot in both trial and control groups was not significantly different (P=0.569, 0.152, 0.696 and 0.703). CONCLUSION:Six IU/mL LMWH added into the intraocular irrigating solution can safely and effectively inhibit intraocular fibrin exudation and inflammation, and no side-effect was found. But it hasn’t direct protection to blood-aqueous barrier of infant rabbit.

R779.66