本文關(guān)鍵詞：青白聯(lián)合手術(shù)治療合并白內(nèi)障的原發(fā)性開(kāi)角型及閉角型青光眼的臨床療效觀察　出處：《中華眼科醫(yī)學(xué)雜志(電子版)》2016年02期 　論文類型：期刊論文

  更多相關(guān)文章： 原發(fā)性開(kāi)角型青光眼 原發(fā)性閉角型青光眼 小梁切除術(shù) 白內(nèi)障超聲乳化摘除術(shù)

【摘要】：目的探討青白聯(lián)合手術(shù)對(duì)合并白內(nèi)障的原發(fā)性開(kāi)角型及閉角型青光眼的療效對(duì)比與術(shù)后并發(fā)癥的發(fā)生率。方法收集2013年8月至2015年9月在深圳市人民醫(yī)院眼科接受白內(nèi)障超聲乳化聯(lián)合人工晶狀體植入術(shù)及復(fù)合式小梁切除手術(shù)的原發(fā)性青光眼合并白內(nèi)障的患者51例(56只眼)的臨床資料。按青光眼類型進(jìn)行分組。其中,原發(fā)性開(kāi)角型青光眼(POAG)組22例(25只眼),原發(fā)性閉角型青光眼(PACG)組29例(31只眼)。用均數(shù)±標(biāo)準(zhǔn)差(xs恕纒)表示患者術(shù)前與術(shù)后的眼壓、前房深度及視力。用配對(duì)t檢驗(yàn)的方法對(duì)比患者術(shù)前與術(shù)后的眼壓、視力及前房深度。用獨(dú)立樣本t檢驗(yàn)的方法對(duì)組間各測(cè)量值進(jìn)行比較。采用例數(shù)和百分比表示POAG與PACG兩組手術(shù)成功率及并發(fā)癥發(fā)生率,并采用卡方檢驗(yàn)對(duì)其進(jìn)行比較。結(jié)果 POAG組的22例(25只眼)患者術(shù)前、術(shù)后1周、術(shù)后1個(gè)月、術(shù)后3個(gè)月、術(shù)后半年及術(shù)后1年的平均眼壓分別為(36.08±5.96)、(12.25±1.85)、(13.88±2.03)、(4.88±2.59)、(16.21±3.58)及(16.92±4.19)mm Hg(1 mm Hg=0.133 k Pa)。將此組患者術(shù)后各時(shí)間點(diǎn)的眼壓與術(shù)前進(jìn)行比較,發(fā)現(xiàn)手術(shù)后患者眼壓均顯著降低,差異均有統(tǒng)計(jì)學(xué)意義(t_1=19.09,17.62,16.54,13.95,13.15;P0.05)。該組患者手術(shù)完全成功率為84%,條件成功率為96%,失敗率為4%。PACG組29例(31只眼)患者術(shù)前、術(shù)后1周、術(shù)后1個(gè)月、術(shù)后3個(gè)月、術(shù)后半年及術(shù)后1年的平均眼壓為(41.32±8.41)、(11.69±2.29)、(13.06±2.32)、(13.9±2.22)、(14.87±3.08)及(15.80±4.35)mm Hg。將此組患者術(shù)后各時(shí)間點(diǎn)的眼壓與術(shù)前進(jìn)行比較,發(fā)現(xiàn)其差異均有統(tǒng)計(jì)學(xué)意義(t_2=18.97,17.86,17.54,16.95,16.30;P0.05)。兩組患者各時(shí)間位點(diǎn)的眼壓差異均無(wú)統(tǒng)計(jì)學(xué)意義(t=1.06,0.11,0.05,0.05,0.00,0.10;P0.05)。聯(lián)合手術(shù)后患者的眼壓均有明顯降低。手術(shù)完全成功率為93.3%,條件成功率為100%,失敗率為0。兩組患者的手術(shù)成功率差異有統(tǒng)計(jì)學(xué)意義(χ~2=4.08,P0.05)。POAG組患者術(shù)前和術(shù)后的前房深度分別為(2.81±0.12)mm和(3.99±0.10)mm,術(shù)后前房深度較術(shù)前均顯著加深(t_1=-37.78,P0.05)。PACG組患者術(shù)前和術(shù)后前房深度分別為(1.82±0.08)mm和(3.79±0.07)mm。術(shù)后前房深度較術(shù)前均顯著加深(t_2=-103.18,P0.05)。兩組患者的術(shù)前前房深度差異具有統(tǒng)計(jì)學(xué)意義(t=20.11,P0.05),而兩組患者的術(shù)后前房深度差異無(wú)統(tǒng)計(jì)學(xué)意義(t2=2.99,P0.05)。POAG組患者術(shù)前視力為(0.28±0.14),術(shù)后1個(gè)月及1年的視力分別為:(0.43±0.23)和(0.40±0.21),術(shù)前與術(shù)后的視力差異具有統(tǒng)計(jì)學(xué)意義(t_1=-2.78,-2.38,P0.05)。PACG組患者術(shù)前視力為(0.21±0.12),術(shù)后1個(gè)月及1年的視力分別為:(0.53±0.17)和(0.45±0.15),術(shù)前視力與術(shù)后視力的差異具有統(tǒng)計(jì)學(xué)意義(t_2=-8.56,-6.45;P0.05)。兩組患者術(shù)前術(shù)后的視力提高幅度差異無(wú)統(tǒng)計(jì)學(xué)意義(t=-1.81,1.87,1.03;P0.05)。POAG組中,患者出現(xiàn)并發(fā)癥者為11只眼(患者術(shù)后發(fā)生的并發(fā)癥涉及多個(gè)種類,部分患眼同時(shí)發(fā)生有多種并發(fā)癥),占44.00%。其中,淺前房者2例,占8.00%;角膜水腫者7例,占28.00%;濾過(guò)泡滲漏者1例,占4.00%;前房出血者2例,占8.00%;炎癥滲出者4例,占16.00%;后發(fā)性白內(nèi)障者2例,占8.00%。PACG組患者中出現(xiàn)并發(fā)癥的為19只眼,占61.29%。其中,淺前房者7例,占22.28%;角膜水腫者13例,占41.94%;脈絡(luò)膜脫離者1例,占3.23%;濾過(guò)泡滲漏者2例,占6.45%;前房出血者4例,占12.90%;炎癥滲出者7例,占22.58%;后發(fā)性白內(nèi)障者3例,占9.67%。PACG組患者的手術(shù)并發(fā)癥顯著高于開(kāi)角型青光眼組,差異有統(tǒng)計(jì)學(xué)意義(χ~2=6.18,P0.05)。結(jié)論青白聯(lián)合手術(shù)對(duì)POAG及PACG合并白內(nèi)障的患者均有較好療效,PACG組的手術(shù)成功率更高,但手術(shù)并發(fā)癥也更多。
[Abstract]:Objective to investigate the incidence of cataract surgery combined with white primary open-angle and curative effect compared with the results of angle closure glaucoma after complications. 51 primary glaucoma complicated with cataract phacoemulsification and intraocular lens implantation and trabeculectomy surgery were collected from August 2013 to September 2015 accept method in the Shenzhen People's Hospital Ophthalmology (56 eyes). The clinical data were grouped according to the type of glaucoma. The primary open-angle glaucoma (POAG) group, 22 cases (25 eyes) of primary angle closure glaucoma (PACG) group of 29 cases (31 eyes). The mean and standard deviation (with XS Chan) said the intraocular pressure and postoperative patients before operation, anterior chamber depth and visual acuity and postoperative intraocular pressure. Using the paired t test compared with preoperative visual acuity and anterior chamber depth. The measured values between the groups were compared by independent sample t test method. 鐢ㄤ緥鏁板拰鐧懼垎姣旇〃紺篜OAG涓嶱ACG涓ょ粍鎵嬫湳鎴愬姛鐜囧強(qiáng)騫跺彂鐥囧彂鐢熺巼,騫墮噰鐢ㄥ崱鏂規(guī)楠屽鍏惰繘琛屾瘮杈，

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