本文關(guān)鍵詞：地塞米松前房注射對(duì)葡萄膜炎并發(fā)白內(nèi)障術(shù)后的臨床研究　出處：《石河子大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 葡萄膜炎 并發(fā)性白內(nèi)障 地塞米松 前房注射 超聲乳化術(shù)

【摘要】：目的 在手術(shù)方式、術(shù)前準(zhǔn)備、術(shù)后處理均相同的情況下，了解葡萄膜炎并發(fā)白內(nèi)障患者行白內(nèi)障超聲乳化+人工晶體植入術(shù)，術(shù)中前房注射0.1ml地塞米松注射液與前房未注射地塞米松注射液兩種不同處理術(shù)后炎癥反應(yīng)的差異，并探討術(shù)中前房注射0.1ml地塞米松注射液術(shù)后對(duì)眼壓的影響情況，以及是否引起其它不良反應(yīng)。 方法 我院自2011年起葡萄膜炎并發(fā)白內(nèi)障患者行白內(nèi)障摘除+人工晶體植入術(shù)，術(shù)中前房注射地塞米松注射液0.1ml。按照病例對(duì)照研究，采用回顧性研究的方法將我院近年來(lái)葡萄膜炎并發(fā)白內(nèi)障行手術(shù)治療的患者分為兩組，如下表所示： A組為對(duì)照組：2011年以前，葡萄膜炎并發(fā)白內(nèi)障的患者，行白內(nèi)障超聲乳化聯(lián)合人工晶體植入術(shù)治療，術(shù)中前房未注射地塞米松注射液； B組為實(shí)驗(yàn)組：2011年以后，葡萄膜炎并發(fā)白內(nèi)障的患者，行白內(nèi)障超聲乳化聯(lián)合人工晶體植入術(shù)治療，術(shù)中前房注射0.1ml地塞米松注射液。 兩組患者均由同一術(shù)者局麻下行小切口白內(nèi)障超聲乳化+人工晶體植入術(shù)，B組在手術(shù)結(jié)束前自手術(shù)切口穿刺入前房注入地塞米松注射液0.1ml，前房維持良好，卡米可林縮瞳，封閉切口后，予以球結(jié)膜下注射2.5mg地塞米松+2萬(wàn)u妥布霉素，手術(shù)結(jié)束。A組在手術(shù)結(jié)束前不做任何特殊處理，前房維持良好，卡米可林縮瞳，封閉切口后，予以球結(jié)膜下注射2.5mg地塞米松+2萬(wàn)u妥布霉素，手術(shù)結(jié)束。兩組術(shù)中均未出現(xiàn)并發(fā)癥，術(shù)后單眼包扎一日。 結(jié)果 術(shù)后前兩日對(duì)照組與實(shí)驗(yàn)組患者視力間差別有統(tǒng)計(jì)學(xué)意義（P=0.0010.05），且實(shí)驗(yàn)組術(shù)后患者視力提高病例數(shù)所占百分比高于對(duì)照組。兩組患者術(shù)后第一天角膜水腫程度的差異具有統(tǒng)計(jì)學(xué)意義（P=0.0370.05），前房閃輝差異有統(tǒng)計(jì)學(xué)意義（P=0.030.05）。兩組患者術(shù)后前房滲出差異無(wú)統(tǒng)計(jì)學(xué)意義（P=0.0870.05）。兩組患者術(shù)后眼壓差異無(wú)統(tǒng)計(jì)學(xué)意義（P=0.1550.05）。 結(jié)論 葡萄膜炎并發(fā)白內(nèi)障患者行白內(nèi)障超聲乳化+人工晶體植入術(shù)，，術(shù)中前房注射0.1ml地塞米松者可減輕短期術(shù)后反應(yīng)，改善角膜水腫情況，可更早提高患者視力，減少術(shù)后用藥次數(shù)，不影響術(shù)后短期眼壓。
[Abstract]:Purpose Under the same operation mode, preoperative preparation and postoperative treatment, the phacoemulsification and intraocular lens implantation was performed in patients with uveitis complicated with cataract. The difference of postoperative inflammatory reaction between 0.1 ml dexamethasone injection and non-dexamethasone injection in anterior chamber. The effect of 0.1 ml dexamethasone injection in anterior chamber on intraocular pressure and other adverse reactions were investigated. Method Since 2011, cataract extraction and intraocular lens implantation have been performed in patients with uveitis complicated with cataract, and 0.1 ml dexamethasone injection was injected into the anterior chamber during the operation. Patients with uveitis complicated by cataract surgery in our hospital in recent years were divided into two groups by retrospective study, as shown in the following table: Group A was treated with phacoemulsification combined with intraocular lens implantation before 2011, and no dexamethasone injection was injected into anterior chamber during operation. Group B: after 2011, cataract patients complicated with cataract were treated by phacoemulsification combined with intraocular lens implantation, and 0.1 ml dexamethasone injection was injected into anterior chamber during operation. Both groups received phacoemulsification and intraocular lens implantation with small incision under the same local anesthesia. Group B received 0.1 ml dexamethasone injection into the anterior chamber from the incision before the end of the operation. The anterior chamber was maintained well. After closing the incision, 2.5 mg dexamethasone 20,000 u tobramycin was injected under the bulbar conjunctiva. The anterior chamber was maintained well. After closing the incision, 2.5 mg of dexamethasone 20,000 u tobramycin was injected under the bulbar conjunctiva. There were no complications in both groups. Postoperative monocular bandaging was performed on 1st. Results The difference of visual acuity between the control group and the experimental group two days before operation was statistically significant (P < 0.0010.05). The percentage of patients with improved visual acuity in the experimental group was higher than that in the control group. The difference of corneal edema between the two groups on the first day after operation was statistically significant (P < 0.05). There was no significant difference in anterior chamber exudation between the two groups (P < 0.05). There was no significant difference in IOP between the two groups. Conclusion Phacoemulsification and intraocular lens implantation was performed in patients with uveitis complicated with cataract. Injection of 0.1 ml dexamethasone in anterior chamber during the operation could alleviate short-term postoperative reaction and improve corneal edema. It can improve the visual acuity of the patients earlier, reduce the times of postoperative medication, and do not affect the short-term IOP after operation.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R773.9;R779.66

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 Mamun-Al Mahtab;Salimur Rahman;Md.Fazal Karim;Mobin Khan;Graham Foster;Susannah Solaiman;Shahrin Afroz;;Epidemiology of hepatitis B virus in Bangladeshi general population[J];Hepatobiliary & Pancreatic Diseases International;2008年06期

2 黃瑞華,王梅芳,汪金方,郁文國(guó);葡萄膜炎并發(fā)性白內(nèi)障31例的手術(shù)治療[J];國(guó)際眼科雜志;2005年03期

3 張紅言;朱思泉;;普拉洛芬滴眼液預(yù)防白內(nèi)障術(shù)后黃斑囊樣水腫的臨床研究[J];國(guó)際眼科雜志;2008年07期

4 陳杰漢;裴育;戴國(guó)圣;張勤;;超聲乳化術(shù)治療葡萄膜炎并發(fā)白內(nèi)障的療效觀察[J];國(guó)際眼科雜志;2010年02期

5 解孝鋒;郭俊國(guó);畢宏生;李麗麗;;清開(kāi)靈滴眼液治療慢性葡萄膜炎的臨床觀察[J];國(guó)際眼科雜志;2010年06期

6 李文利;李麗波;;葡萄膜炎并發(fā)白內(nèi)障的手術(shù)治療[J];國(guó)際眼科雜志;2011年08期

7 余彬,吳靜安;糖皮質(zhì)激素對(duì)保存角膜的影響[J];國(guó)外醫(yī)學(xué).眼科學(xué)分冊(cè);1990年02期

8 李光達(dá);張曉敏;李筱榮;;實(shí)驗(yàn)性自體免疫性葡萄膜炎的治療研究進(jìn)展[J];眼科新進(jìn)展;2011年09期

9 趙靜;張琦;;糖皮質(zhì)激素性青光眼小梁細(xì)胞超微結(jié)構(gòu)的改變[J];眼科學(xué)報(bào);2010年02期

10 姜興華,石雁,譚洪,宋玉偉;白內(nèi)障超聲乳化及人工晶狀體植入術(shù)后遲發(fā)性葡萄膜炎的臨床分析[J];眼科研究;2004年06期

本文編號(hào)：1360728