本文選題：糖尿病 + 白內(nèi)障超聲乳化手術(shù)��； 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]研究糖尿病患者白內(nèi)障超聲乳化手術(shù)后黃斑中心凹脈絡(luò)膜厚度(SFCT)的變化,探究白內(nèi)障超聲乳化手術(shù)對SFCT變化的影響,及術(shù)后SFCT變化與術(shù)前空腹血糖、糖化血紅蛋白之間的關(guān)系。[方法]本研究納入40例患者,20例為糖尿病白內(nèi)障患者,20例為非糖尿病白內(nèi)障患者。所有患者行白內(nèi)障超聲乳化摘除合并人工晶體植入術(shù),患者術(shù)前抽血檢測空腹血糖和糖化血紅蛋白。用標準對數(shù)視力表檢測術(shù)前、術(shù)后1周、1月、3月最佳矯正視力,采用Mann-Whitney U檢驗分析。應(yīng)用EDI-OCT分別測量患者術(shù)前、術(shù)后1周、1月、3月SFCT值,采用重復(fù)測量方差分析及SNK-q檢驗對測量數(shù)據(jù)進行分析。多元線性回歸分析患者術(shù)前及術(shù)后各時間點SFCT變化與年齡、糖尿病病程時間、空腹血糖、糖化血紅蛋白的相關(guān)性。[結(jié)果]兩組患者術(shù)前、術(shù)后1月、術(shù)后3月最佳矯正視力(BCVA)比較差異無統(tǒng)計學(xué)意義(P0.05),術(shù)后1周非糖尿病組的BCVA好于糖尿病組(P0.01)。糖尿病組術(shù)前、術(shù)后1周、1月、3月SFCT分別為(174.15 ± 37.65)μm、(188.58±42.42)μm、(197.07±45.54)μm、(194.11 ±44.83)μm。非糖尿病組術(shù)前、術(shù)后1周、1月、3月SFCT分別為(168.26± 36.59)μm、(181.50± 44.25)μm、(184.50± 44.38)μm、(183.13± 43.93)μm。糖尿病組與非糖尿病組患者術(shù)后SFCT值增加,術(shù)后1月時最厚,術(shù)后3月SFCT值相比較于術(shù)后1月有所回落,但仍大于術(shù)后1周測量值。兩組患者術(shù)前、術(shù)后各時間點SFCT值兩兩比較差異均有統(tǒng)計學(xué)意義(P0.05)。多元線性回歸分析結(jié)果顯示糖尿病組患者術(shù)前、術(shù)后各時間點SFCT變化與術(shù)前空腹血糖呈正相關(guān)性,而與年齡、糖尿病病程時間、糖化血紅蛋白無明顯相關(guān)性。[結(jié)論]白內(nèi)障超聲乳化手術(shù)對患者術(shù)后黃斑中心凹脈絡(luò)膜厚度變化存在影響,糖尿病患者術(shù)前血糖控制水平對白內(nèi)障超聲乳化術(shù)后黃斑中心凹脈絡(luò)膜厚度變化存在影響,而年齡、糖尿病病程時間、近期血糖控制水平對術(shù)后黃斑中心凹脈絡(luò)膜厚度變化影響不大。
[Abstract]:[objective] to study the changes of central foveal choroidal thickness (SFCT) after phacoemulsification in diabetic patients, and to explore the effect of phacoemulsification on the changes of SFCT, the changes of SFCT and fasting blood glucose before operation. The relationship between glycosylated hemoglobin. [methods] A total of 40 patients with diabetic cataract and 20 patients with non-diabetic cataract were included in this study. All patients were treated with phacoemulsification and intraocular lens implantation. Fasting blood glucose and glycosylated hemoglobin were measured before operation. Standard logarithmic visual acuity chart was used to detect the best corrected visual acuity before operation, 1 week, 1 month and 3 months after operation. Mann-Whitney U test was used. EDI-OCT was used to measure the SFCT values before operation, 1 week, 1 month and 3 months after operation, and repeated measurement variance analysis and SNK-q test were used to analyze the measured data. Multivariate linear regression analysis showed that SFCT changes were correlated with age, duration of diabetes, fasting blood glucose and glycosylated hemoglobin in patients before and after operation. [results] there was no significant difference in BCVA between the two groups before operation, one month after operation and three months after operation. The BCVA in the non-diabetic group was better than that in the diabetic group at 1 week after operation. Before operation, 1 week, 1 month and 3 months after operation, the SFCT in the diabetic group was 188.58 鹵42.42 渭 m and 194.11 鹵44.83 渭 m respectively. Before operation, 1 week, 1 month and 3 months after operation, the SFCT of non-diabetic group was 181.50 鹵44.25 渭 m and 184.50 鹵44.38 渭 m respectively, the SFCT was 183.13 鹵43.93 渭 m. The SFCT value of diabetic group and non-diabetic group increased after operation, and the thickest one month after operation. The SFCT value of 3 months after operation was lower than that of 1 month after operation, but still larger than the measured value at 1 week after operation. There were significant differences in SFCT values before and after operation between the two groups (P 0.05). The results of multiple linear regression analysis showed that the changes of SFCT were positively correlated with fasting blood glucose before and after operation, but not with age, duration of diabetes, glycosylated hemoglobin. [conclusion] the effect of phacoemulsification on the choroidal thickness of macular central fovea after cataract phacoemulsification, and the effect of blood glucose control on the thickness of central foveal choroidal thickness after phacoemulsification in diabetic patients. However, age, duration of diabetes, and the level of blood glucose control had little effect on the thickness of central foveal choroid.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R587.2;R779.6

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