兔眼房水中丁酰化壳聚糖丝裂霉素药膜的释放性能

目的：研究丁酰化壳聚糖丝裂霉素药膜在兔眼房水中的释放性能。方法：应用高效液相色谱法分别在0．25,0．5,1,2,3,6,24h行前房穿刺术,抽取房水测定植入兔眼巩膜瓣下的丁酰化壳聚糖丝裂霉素药膜中MMC在房水中的含量。设对照组,为另1眼巩膜表面放置MMC棉片(MMC0．25g／L)5min,NS冲洗。结果：植入药膜组0．25,0．5,1,2h后的房水中可检测出MMC,含量22．5～130．3μg／L(最低检测浓度10μg／L)对照组仅在0．25,0．5h的房水中检测到MMC。结论：丁酰化壳聚糖丝裂霉素药膜植入兔眼小梁切除术的巩膜瓣下具有一定的缓释作用。     

难治性青光眼小梁切除术术中调整巩膜瓣缝线的效果

目的探讨小梁切除术术中调整巩膜瓣缝线联合应用丝裂霉素C（MMC）治疗难治性青光眼的效果。方法对58例（58眼）难治性青光眼采取小梁切除术，术中调整巩膜瓣缝线并应用MMC。观察术后视力、滤过泡、角膜、前房、晶状体、眼底、眼压等。随访6～18月。结果术后有50眼（86．21％）的眼压≤21mmHg；3眼（5．17％）加用眼局部降眼压药物治疗，眼压〈30mmHg；5眼（8．62％）的眼压无改善。结论在小梁切除术术中调整巩膜瓣缝线联合应用MMC是治疗难治性青光眼的有效方法之一。     

晶状体前囊膜应用于兔小梁切除术的实验研究

目的探讨兔眼小梁切除术中联合晶状体前囊膜植入的疗效及机制。设计随机对照实验性研究。研究对象新西兰白兔36只。方法36只兔随机分成3组,分别行小梁切除联合兔晶状体前囊膜植入、小梁切除联合人晶状体前囊膜植入以及单纯小梁切除术对照组。随访时间12周。主要指标眼压、滤过泡、并发症。结果小梁切除联合兔晶状体前囊膜植入组及人晶状体前囊膜植入组术后12周眼压分别为(18．66±2．61)mmHg、(18．91±2．04)mmHg,仍明显低于术前(22．58±0．51)mmHg、(22．21±0．69)mmHg(P均＜0．05)。两实验组功能性滤过泡平均存留时间高于对照组,分别为(5．12±0．43)周、(5．05±0．59)周,(2．74±0．32)周(P＜0．05)。光镜观察实验组术后12周滤过道开放,对照组滤过道基本闭合;电镜观察晶状体前囊膜未见T及B淋巴细胞浸润。结论小梁切除术联合晶状体前囊膜植入可推迟滤过道瘢痕形成,为临床应用提供了理论基础及实验依据。(眼科,2007,16: 52-55)     

改良巩膜瓣小梁切除与传统小梁切除的疗效观察

目的　了解小梁切除术中改良巩膜瓣、不同缝合方式在术中、术后的优缺点。方法　 90例 116眼青光眼患者随机分为 3组 :传统术式组 30例 4 2眼 ;可拆褥式缝线组 30例 4 0眼 ;L形巩膜瓣小梁切除组 30例 34眼。比较 3组术后浅前房、眼压和滤过泡情况。结果　浅前房发生率传统术式组 2 6 18% ,可拆褥式缝线组 7 5 % ,L形巩膜瓣切除组2 94 % ,改良巩膜瓣组与传统术式组比较有非常显著性差异(P <0 0 1) ;随诊眼压传统术式组 (14 6 5± 4 30 )mmHg(1kPa =7 5mmHg) ,可拆褥式缝线组 (13.87± 3.6 0 )mmHg ,L形巩膜瓣切除组 (15 .5 8± 3.2 0 )mmHg ,3组间差异无显著性 (P >0 0 5 ) ;随诊功能性滤过泡传统术式组 76 % ,可拆褥式缝线组 93% ,L形巩膜瓣切除组 96 % ,传统小梁切除组与改良巩膜瓣小梁切除组比较差异有显著性 (P <0 .0 5 )。结论　采用巩膜瓣可拆褥式缝合与L形巩膜瓣小梁切除可大大降低术后浅前房的发生率 ,并能理想地控制眼压 ,提高术后视功能     

可拆缝线小梁切除术全过程滤过试验的意义

目的观察在巩膜瓣可拆缝线小梁切除术全过程滤过试验的应用及效果。方法在64例（78眼）巩膜瓣可拆缝线小梁切除术全过程中应用滤过试验。即小梁切除、巩膜瓣缝合、结膜缝合后，经前房穿刺口各进行1次前房注水。通过全过程滤过试验来检验滤过情况并加以调整。观察术后前房深度，眼压，滤过泡。结果术后无发生持续性浅前房者。术后第7天眼压在11．7～18．0mmHg之间。术后7～14天，全部病例拆除可拆缝线，眼压在9．8—14．8mmHg之间。追踪观察6月，形成功能性滤过泡66眼（84．62％）。结论在巩膜瓣可拆缝线小梁切除术全过程应用滤过试验，可以有效预防术后浅前房的发生，充分发挥可拆缝线的作用，提高手术的质量和安全性。     

巩膜池成形联合小梁切除术+MMC临床评价

目的探讨巩膜池成形联合小梁切除术 MMC治疗原发性青光眼的临床效果并进行评价。方法采用前瞻随机对照实验。将68例68眼随机分为A、B两组,A组行小梁切除术 MMC术B组行巩膜池成形联合小梁切除术 MMC术,术后随访6个月,比较观察术后并发症和眼压变化情况。结果术后6个月A组平均眼压为19.7mmHg,B组平均眼压为14.5mmHg,差异有统计学意义(p<0.05),术后一周内浅前房低眼压,A组18.8%、B组5.5%;脉络膜脱离,A组22.2%、B组8.3%结论巩膜池成形联合小梁切除术 MMC降压效果、安全性均优于单纯小梁切除术 MMC术,并且术后早期并发症发生率低。     

小梁切除联合胶原膜植入治疗青光眼

目的观察小梁切除联合胶原膜植入治疗青光眼的效果。方法17眼青光眼做小梁切除术联合胶原膜填充于巩膜瓣下,术后观察其降压效果及并发症。结果术后出院时眼压平均10.8±3.3mmHg,术后3mo眼压平均13.0±3.9mmHg,术后1a平均眼压15.3±5.4mmHg,术后2a平均眼压16.8±4.2mmHg,手术前后眼压统计学处理有意义,术后未出现严重并发症。结论小梁切除联合胶原膜植入治疗青光眼,能有效控制眼压,该术式操作方便、安全、有效。     

壳聚糖膜缓释给药系统在小梁切除术中的应用

目的观察壳聚糖膜缓释给药系统在小梁切除术中应用的组织反应以及降眼压效果。方法24只48眼新西兰大白兔随机分成A、B、C3组，A组单纯行小梁切除术。作为手术对照；B组行小梁切除术联合壳聚糖膜巩膜瓣下植入；C组行小梁切除术联合曲安奈德壳聚糖膜缓释给药系统巩膜瓣下植入。术后观察眼压、炎症反应、结膜滤泡等，并分别于7d、14d、28d、56d取标本行组织学检查。结果术前各组平均眼压为（23．10±3．92）mmHg（1kPa=7．5mmHg），术后8周A组平均眼压为（21．73±2．90）mmHg，B组平均眼压为（15．64±2．74）mmHg，C组平均眼压为（15．42±2．98）mmHg，B、C组与A组之间有显著性差异（P〈0．05），B、C组间无显著差异（P〉0．05）。B、C组8周植入材料有断裂现象，其周围有组织间隙和滤泡存在，无明显纤维组织增生；C组炎性细胞浸润现象好于B组；A组组织结构紊乱、瘢痕形成，未见组织间隙和滤泡。结论壳聚糖膜缓释给药系统作为小梁切除术的植入材料有良好的组织相容性，有一定抑制纤维组织增生的作用，能够有效维持滤过，降眼压效果满意。     

部分睫状体冷凝联合小梁切除治疗新生血管性青光眼

目的评价部分睫状体冷凝联合小梁切除术治疗新生血管性青光眼的效果。方法对32例（32眼）药物难于控制的新生血管性青光眼,首先进行180°范围内睫状体冷凝然后联合施行巩膜瓣下小梁切除与虹膜周边切除,术中巩膜瓣下应用丝裂霉素C。术后处理同常规小梁切除术。随访时间6～12个月。结果32例术后第1周眼压较术前明显降低。随访期间眼压控制良好。功能性滤过泡（Ⅰ型和Ⅱ型）87．96％,非功能性滤过泡（Ⅲ型）5．06％,薄壁滤过泡3．65％。结论采用180°范围内睫状体冷凝联合施行巩膜瓣下小梁切除联合应用MMC治疗新生血管性青光眼,是一种较安全有效的综合治疗方法。     

闭角型青光眼巩膜隧道下小梁切除术临床观察

目的探讨闭角型青光眼巩膜隧道下小梁切除术的临床效果。方法观察组44例（55眼）,施行巩膜隧道下小梁切除术。对照组58例（70眼）,施行三角形板层巩膜瓣下小梁切除术。结果术后视力观察组平均0．45,对照组平均o．38。术后眼压观察组出院时平均12mmHg,对照组出院时平均12mmHg。术后浅前房发生率：观察组13眼（23．64％）,对照组21眼（28．57％）,卡方检验x2=0．63,P〉0．05。术后包裹性滤过泡,观察组无,对照组5眼（7．14％）,卡方检验x2=4．09,P〈0．05。结论闭角型青光眼巩膜隧道下小梁切除术后视力稳定,眼压控制良好,浅前房发生率不高,包裹性滤过泡发生率低。     

Comparison of standard trabeculectomy versus microtrabeculectomy as a surgical treatment for glaucoma: a randomized clinical trial

Background: To determine the effect of scleral flap size on the medium‐term intraocular pressure control and complication rates after augmented trabeculectomy. Design: Prospective randomized clinical trial. Participants: Glaucoma patients undergoing primary trabeculectomy. Exclusion criteria included previous ocular surgery apart from cataract surgery, secondary glaucoma and age under 18. Methods: Patients were randomized to either standard trabeculectomy (4 × 4 mm scleral flap) or microtrabeculectomy (2 × 2 mm scleral flap), both with adjustable sutures and antimetabolites. Bleb needling was performed as required. Patients were evaluated at day 1, weeks 1, 3, 6 and months 3, 6, 12, 18 and 24 postoperatively. Main Outcome Measures: Vision, intraocular pressure, complications and failure (intraocular pressure ≥ 21 mmHg or not reduced by ≥20% from baseline, intraocular pressure ≤ 5 mmHg, repeat glaucoma surgery and no light perception vision). Results: Forty‐one patients were recruited; 20 had standard trabeculectomy, and 21 had microtrabeculectomy. At 2 years, the mean intraocular pressure and cumulative probability of failure was 12.4 ± 4.6 mmHg and 0.28 for standard trabeculectomy, and 11.5 ± 3.6 mmHg and 0.27 for microtrabeculectomy (P = 0.50 and 0.89, respectively). One patient in each group required Baerveldt device implantation. Vision reduced ≥2 Snellen lines in 15% in the standard trabeculectomy group and 25% in the microtrabeculectomy group, mainly from cataract (P = 0.48). Conclusion: Both trabeculectomy techniques achieved good intraocular pressure reduction and had similar complication rates. Scleral flap size had no significant effect on medium‐term intraocular pressure control and complication profile.     

巩膜蓄水池样复合式小梁切除术治疗难治性青光眼

目的 探讨巩膜瓣下蓄水池样小梁切除术联合羊膜移植及术中应用丝裂霉素C治疗难治性青光眼的临床效果.方法 将不同类型的难治性青光眼95例(102眼)随机分为2组,观察组48例(52眼)行巩膜蓄水池式小梁切除术联合羊膜植入及术中应用丝裂霉素C和可调整缝线,对照组47例(50眼)行常规的小梁切除术.术后随访4～15个月.结果 术后视力两组间比较差异无统计学意义(x2=1.14,P=0.75).术后2周两组眼压均较其术前为低差异有统计学意义,而组间比较差异无统计学意义(=1.86,P=0.08);术后6个月观察组平均眼压(14.75±3.87 )mm Hg,对照组(19.25±7.14) mm Hg;手术成功率:观察组86.54％,对照组64.00％,观察组成功率较高,两组间差异有统计学意义(x2=3.85,P＜0.05).功能性滤过泡观察组83.0％,对照组61.4％,两组比较差异有统计学意义(x2=5.53,P=0.02).术后观察组出现浅前房较对照组多,治疗后1周均恢复正常.结论 与常规小梁切除术相比,巩膜蓄水池样小梁切除术联合羊膜植入及术中应用丝裂霉素C和可调整缝线治疗难治性青光眼,在防止滤过道瘢痕形成,术后控制眼压等方面有一定优势.     

巩膜层间引流池加用丝裂霉素C治疗难治性青光眼疗效观察

目的探讨巩膜层间引流池加用丝裂霉素C治疗难治性青光眼的临床疗效。方法采用巩膜层间引流池应用丝裂霉素C治疗难治性青光眼44例（50眼）。术后对眼压、视力、前房、滤过泡形态进行观察。随访6-15个月,并总结分析疗效。结果 44例50眼中44眼眼压〈21 mmHg,成功率在88.0%;3眼眼压22-24 mmHg,无任何自觉症状。2眼眼压在25-30 mmHg,有自觉症状,需用降眼压药物维持。总有效率占98.0%。结论该术式在眼压控制、滤过泡形成等方面效果较好。     

取得更低眼压的青光眼复合小梁切除手术方法

目的 探索取得更低眼压水平的安全的青光眼复合小梁切除手术方法.方法 观察接受复合小梁切除手术的65岁以下的原发慢性闭角型青光眼和原发开角型青光眼病人81例(98只眼),随机分为两组,即改良组和标准组.改良组25例患者(31只眼),巩膜瓣为5 mm×3 mm×5 mm长方形,约1/4～1/3厚,缝3针可调节缝线;标准组56例患者(67只眼),巩膜瓣5 mm×4 mm×4mm梯形,约1/2～1/3厚,缝2针可调节缝线,分析两组手术后浅前房发生率和3月时眼压情况.结果 浅前房情况:改良组31只眼,5例5只眼发生浅前房,其发生率为16.1%;标准组67只眼,5例5只眼发生浅前房,其发生率为7.5%.经x2检验分析,两组浅前房发生率的差别无统计学显著性意义(x 2=1.74,P＞0.1).手术后3个月眼压:改良组为8.1～16.5 mm Hg,平均为(12.5±1.9)mm Hg,而标准组为8.9～24.8 mm Hg,平均为(16.4±3.6)mm Hg,经t检验,两组均值的差异有统计学意义(t=2.36,P＜0.05).结论 与普遍采用的标准复合小梁切除手术相比,改良的复合小良切除手术后获得更低的眼压水平,同时浅前房发生率低.

Abstract：

Objective To explore save complex trabeculectomy to achieve lower intraocular pressure in glaucoma. Methods Eighty-one patients (98 eyes) with primary cbronic glaucoma received complex trabeculectomy in our hospital and were reviewed. All of the patients were divided into two groups according to the number of adjustable sutures of the operated eyes. The two groups were the modified and the standard. There were 25 cases (31 eyes) in modified group. All of the eyes had received complex trabeculectomy with 3 adjustable sutures and a scleral flap of 5×3×5mm and 1/4～1/3 sclera thick. There were 56 cases (67 eyes) in standard group. All of the eyes' had received complex trabeculectomy with 2 adjustable sutures and a scleral flap of 5×4×4 mm and 1/2～1/3 sclera thick The incidence rates of shallow anterior chamber and the intraocular pressures 3 months after operation were analyzed retrospectively. Results Shallow anterior chamber: There were 5 cases (5 eyes)occurrence in modified group (3leyes) with incidence rate of 16.1%. Among them 3 were the grade I and 2 were grade II. There were 5 cases (5 eyes) occurrence in standard group (67 eyes) with incidence rate of 7.5%. Among them 2 were the grade 1, 2 were grade Ⅱ and Ⅰ was grade Ⅲ. An alyzed by chi square test, the difference of.the incidence rates of the two groups was no signiificant statisticaUy (X2=1.74, P＞0.1). Intraocular pressures 3 months post-operation: The range of the pressure was 8.1 to 16.5 mmHg with the average of 12.5± 1.9 mmHg in modified group. The other range of the pressure was 8.9 to 24.8 mmHg with the average of 16.4± 3.6 mmHg in standard group. Analyzed by t test, the difference of the averages of the two groups was statistically significant (t=2.36, P ＜0.05). Conclusions Compared with the standard complex trabeculectomy which is common used by eye doctors at present the modified complex trabeculectomy is more effective for glaucoma to get the intraocular pressure at lower level after operation and the incidence of shallow anterior chamber is low.     

层间巩膜瓣切除联合小梁巩膜条转移治疗青光眼疗效观察

目的探讨层间巩膜瓣切除联合小梁巩膜条转移治疗青光眼的疗效。方法收集2010年5月至2011年2月在我院眼科住院治疗的青光眼患者42例(51眼),分为治疗组(21例26眼)与对照组(21例25眼)。治疗组采用层间巩膜瓣切除联合小梁巩膜条转移术,对照组采用常规小梁切除术。术后观察两组视力、眼压、滤过泡情况及并发症。采用SPSS17.0软件进行统计学处理。结果术后两组视力均较术前有所改善,治疗组改善更为明显。治疗组手术后眼压明显下降,至随访12个月时眼压为(14.46±1.92)mmHg(1kPa=7.5mmHg)。对照组手术后眼压亦明显下降,至随访12个月时眼压为(19.27±1.76)mm-Hg,差异有统计学意义(P<0.05)。术后12个月治疗组功能性滤过泡发生率所占比例为88.5%,对照组为60.0%,差异有统计学意义(P<0.05)。治疗组26眼中7眼出现浅前房,对照组仅3眼术后出现浅前房。治疗组Ⅰ级前房积血3眼,对照组Ⅰ级前房积血3眼,术后3～5d可完全吸收。治疗组5眼出现低眼压,对照组3眼出现低眼压,术后8d内眼压缓慢回升。结论层间巩膜瓣切除联合小梁巩膜条转移操作相对简单,手术安全,远期降眼压效果明显,值得临床推广应用。     

Fibrin glue as a suture substitute: histological evaluation of trabeculectomy in rabbit eyes

PURPOSE: To describe the outcome of the use of fibrin adhesive (Quixil) in penetrating trabeculectomy in a rabbit model. METHODS: Fibrin adhesive was used experimentally to attach the conjunctiva and the scleral flap in two groups of 17 New Zealand albino adult rabbits (34 eyes). In the first experiment (20 eyes), the fibrin adhesive was used to reattach the tissue after conjunctival peritomy and scleral flap only in 14 eyes (experiment I). In 6 eyes (controls), the conjunctiva was attached with nylon sutures. In the second experiment (14 eyes), the fibrin adhesive was used after conjunctival peritomy, scleral flap, and penetrating trabeculectomy in 8 eyes (experiment II). In a control group of 6 eyes, nylon sutures were used to attach the scleral flap and the conjunctiva after penetrating trabeculectomy. Biomicroscopy and histopathological examinations were performed on postoperative days 1, 3, 7, 14, 21, and 30. Intraocular pressure was measured before and after surgery in the second experiment. Main outcome measures are histological presence of adhesive in the tissue, degree of capillary congestion, inflammatory reaction, collagen density [scar formation] and clinical (IOP measurements before and after surgery, conjunctival chemosis, anterior chamber reaction, presence of filtering bleb and wound leakage). RESULTS: In experiments I and II, the adhesive was well identified histologically in the tissue as an amorphic eosinophilic substance for up to day 3 and nearly disappeared by day 7. An acute inflammatory reaction was noted for up to 14 days, which converted to chronic inflammation with collagen deposits and scar formation by day 30. Similar inflammatory reaction was observed in the control group. The adhesive had no adverse effects on ocular tissue compared with sutures. One eye in experiment II demonstrated wound dehiscence. Intraocular pressure dropped from 17.35 mmHg preoperatively to 8.28 mmHg on postoperative day 1 in experiment II, and from 17.2 mmHg to 11.5 mmHg in the controls. No significant change in intraocular pressure was noted in experiment I. CONCLUSIONS: The fibrin adhesive had no adverse effects on ocular tissue compared with sutures. It might serve as an effective substitute for conjunctival and scleral wound closure in trabeculectomy surgery.     

隧道式小切口在青光眼白内障联合手术中的应用

目的探讨隧道式小切口白内障囊外摘除后房型人工晶体植入联合小梁切除术（即小切口三联术）的临床效果。方法不同类型的青光眼伴白内障患者38例42眼,行隧道式小切口白内障囊外摘除后房型人工晶体植入联合小梁切除术,术后随访6-24月,平均12.5月,对视力,眼压,滤过泡及并发症进行临床观察。结果术后随访视力≥0.5者26眼,占61.9%;0.2-0.4者9眼,占21.4%,视力〈0.2者7眼,占16.7%。眼压控制在正常范围（〈21mmHg）38眼,占90.5%,4眼术后眼压在21-24.38mmHg,用噻吗洛尔眼水滴眼,眼压可控制正常。功能性滤过泡占80.9%,无严重并发症。结论隧道式小切口白内障摘除及后房型人工晶体植入联合小梁切除是既有效,又经济的治疗方法,值得推广。     

青光眼巩膜瓣下蓄水池样小梁切除术的临床研究

目的评价巩膜瓣下蓄水池样小梁切除术治疗青光眼的效果。方法回顾54例（64眼）青光眼的治疗情况。观察组26例（32眼）采用巩膜瓣下蓄水池样小梁切除术;对照组28例（32眼）采用传统小梁切除术。术后随访6个月,观察比较两组术后眼压、滤过泡及并发症情况。结果术后6个月观察组平均眼压为（16.2±4.2）mmHg,对照组平均眼压为（19.8±6.2）mmHg,（P〈0.01）,观察组功能性滤过泡形成率明显高于对照组（P〈0.01）,并发症发生率低于对照组（P〈0.05）。结论巩膜瓣下蓄水池样小梁切除术降压效果、安全性均优于传统小梁切除术,并发症少,是一种较好的抗青光眼手术方式。     

吡非尼酮浸泡生物羊膜对兔青光眼模型滤过术后瘢痕形成的作用

目的:探讨吡非尼酮(PFD)浸泡生物羊膜在兔青光眼模型中的应用,评价其对兔青光眼模型的抗瘢痕效果及毒副作用。方法:健康新西兰白兔72只右眼采用前房注射复方卡波姆溶液的方法建立青光眼模型后随机分为0.5%PFD+生物羊膜组、单纯生物羊膜组、丝裂霉素C(MMC)组和空白对照组,每组18只,均行小梁切除术,其中0.5%PFD+生物羊膜组在巩膜瓣下放置0.5%PFD溶液浸泡的生物羊膜,单纯生物羊膜组在巩膜瓣下放置生理盐水浸泡的复水生物羊膜,MMC组在巩膜瓣下放置浸有MMC的棉片3 min后立即采用生理盐水冲洗,空白对照组制作巩膜瓣后不放入任何植入物。评估眼压、滤过泡及毒副作用和并发症情况,并采用苏木精-伊红(HE)、Masson染色及免疫组织化学染色法观察滤过区组织病理变化。结果:小梁切除术后14、21、28 d各组眼压比较,0.5%PFD+生物羊膜组相似文献   

青光眼小梁切除术后滤过道阻塞的处理

目的探索青光眼小梁切除术后滤过道阻塞等并发症的治疗方法。方法根据我科2010年6月至2013年5月28例（33）眼术后1个月内发生滤过道阻塞患者的临床资料进行总结,参照小梁切除术后滤过道阻塞不同部位采取不同的方法治疗。在术后1个月内切口粘连不紧密时,内部阻塞者通过缩瞳、经角膜侧切口将前粘连的周边虹膜切除口分离,必要时扩大虹膜切口,恢复周边前后房的交通;中部阻塞者重建小梁切口,确保其通畅;外部阻塞者术后1个月内进行结膜瓣、巩膜瓣剥离。结果33眼术后视力情况：5眼视力≤0．1,18眼0．2～0．5,10眼≥0．6。术后眼压12～21mmHg,平均（16．3±3．9）mmHg（1mmHg=0．133kPa）。眼压与术前比较,差异有统计学意义。随访半年,眼压稳定在15～22mmHg,平均（17．3±3．9）mmHg。3例再次手术后需用0．25％噻吗洛尔控制眼压在20mmHg以下。有3例外部滤过道阻塞者行巩膜瓣剥离后出现浅前房。结论小梁切除术后1个月内发生滤过道阻塞者,由于切口愈合并不十分牢固,采取适当的措施是可以恢复滤过功能的。