【摘要】：目的分析老年性白內(nèi)障超聲乳化聯(lián)合人工晶狀體(IOL)植入術(shù)后發(fā)生醫(yī)療糾紛的原因。設(shè)計(jì)回顧性病例系列。研究對(duì)象北京同仁醫(yī)院2012-2016年老年性白內(nèi)障患者行超聲乳化聯(lián)合IOL植入術(shù)后糾紛患者58例。方法對(duì)術(shù)后糾紛比例、性別、年齡、術(shù)眼順序、投訴主要內(nèi)容描述及糾紛處理結(jié)果進(jìn)行統(tǒng)計(jì)分析。主要指標(biāo)糾紛比例、糾紛因素。結(jié)果 58例患者中51~80歲者50例(86.21%),女性33例(56.90%),雙眼均手術(shù)者12例(20.69%)。投訴時(shí)間在術(shù)后4~6個(gè)月者41例(70.69%)。角膜水腫、角膜炎致患者術(shù)后視物模糊、異物感、磨痛投訴者16例(27.59%),黃斑前膜、黃斑水腫、高度近視致視力不提高或下降者15例(25.86%),玻璃體混濁術(shù)后飛蚊加重12例(20.69%),術(shù)后IOL下移致重影、眩光、頭暈4例(6.90%),術(shù)后繼發(fā)性青光眼3例(5.17%),后囊膜破裂致第一次手術(shù)時(shí)未植入IOL 1例(1.72%),眼內(nèi)炎1例(1.72%),術(shù)后屈光不正致視近物不清楚1例(1.72%)。結(jié)論術(shù)后各種視覺(jué)不適相關(guān)癥狀及視力不提高是老年性白內(nèi)障術(shù)后糾紛的主要原因,術(shù)前應(yīng)充分與患者溝通及解釋。
[Abstract]:Objective to analyze the causes of medical disputes after phacoemulsification combined with intraocular lens (IOL) implantation for senile cataract. Design retrospective case series. Participants 58 patients with senile cataract after phacoemulsification and IOL implantation were enrolled in the study. Methods the proportion of disputes, sex, age, eye order, the main contents of complaints and the results of dispute resolution were analyzed statistically. Main indicators: proportion of disputes, factors of disputes. Results 50 cases (86.21%) were aged 51 to 80 years old, 33 cases (56.90%) were female, 12 cases (20.69%) were bilateral operation. The time of complaint was 4 ~ 6 months after operation in 41 cases (70.69%). Corneal edema, keratitis caused by postoperative blurred vision, foreign body sensation, abrasion pain in 16 cases (27.59%), macular membrane, macular edema, high myopia caused by visual acuity did not improve or decrease in 15 cases (25.86%). After vitreous opacification, 12 cases (20.69%) were aggravated, 4 cases (6.90%) were dizziness, 4 cases (6.90%) were dizziness, 3 cases (5.17%) were secondary glaucoma. IOL was not implanted in 1 case (1.72%), endophthalmitis in 1 case (1.72%) and ametropia in 1 case (1.72%). Conclusion the main causes of postoperative disputes of senile cataract are various symptoms related to visual discomfort and no improvement of visual acuity, which should be fully communicated and explained before operation.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京同仁醫(yī)院北京同仁眼科中心眼科學(xué)與視覺(jué)科學(xué)北京市重點(diǎn)實(shí)驗(yàn)室;首都醫(yī)科大學(xué)附屬北京同仁醫(yī)院醫(yī)務(wù)處;
【分類號(hào)】：R197.323;R779.66

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