本文選題：葡萄膜炎　切入點：臨床特點　出處：《新疆醫(yī)科大學》2011年碩士論文　論文類型：學位論文

【摘要】：目的：探討葡萄膜炎的臨床特點及玻璃體切除術治療葡萄膜炎臨床療效的影響因素。方法：對2004年1月～2009年12月在蘭州軍區(qū)烏魯木齊總醫(yī)院眼科住院治療的各類葡萄膜炎患者共184例216眼的臨床資料進行回顧性分析。觀察葡萄膜炎患者的性別、年齡、病因、病程、解剖分類、復發(fā)次數(shù)、治療方法、治療前后視力和眼部體征的變化、并發(fā)癥的發(fā)生情況。用統(tǒng)計學方法對治療前后視力、眼部體征的變化及并發(fā)癥的發(fā)生情況進行統(tǒng)計學分析。根據(jù)治療前后視力、眼部體征的變化及并發(fā)癥發(fā)生情況判定臨床療效。對48例54眼行玻璃體切除術的葡萄膜炎患者,綜合比較不同的性別、年齡、病因、病程、解剖分類、復發(fā)次數(shù)對其玻璃體切除術臨床療效的影響,用統(tǒng)計學方法對各種分組的臨床療效的差異性進行統(tǒng)計學分析。結果：本組各種葡萄膜炎患者共184例216眼,男性142例164眼,女性42例52眼。以21-40歲患者居多(100例占54.3%)。病因：其中以特發(fā)性葡萄膜炎為主(103例占56.0%)其次為外傷性葡萄膜炎(23例占12.5%)。病程：急性葡萄膜炎155眼(71.8%)；慢性葡萄膜炎61眼(28.2%)。解剖分類：以前葡萄膜炎為主(136眼占63.0%)；其次為全葡萄膜炎(61眼占28.2%)。復發(fā)次數(shù)：住院時既往復發(fā)次數(shù)：0次共163眼(75.5%),0-2次者共20眼(9.2%),3-4次者共28眼(13.0%),5次及以上者共5眼(2.3%)。治療：采取單純藥物治療共154眼(71.3)%,藥物聯(lián)合手術治療共62眼(28.7%),其中行玻璃體切除術者共54眼。并發(fā)癥：治療前無并發(fā)癥共81眼(37.5%),有并發(fā)癥135眼(62.5%)；治療后無并發(fā)癥共144眼(66.7%),有并發(fā)癥共72眼33.3%)。本組216眼痊愈共53眼(24.5%),顯效83眼(38.5%),有效69眼(31.9%),無效11眼(5.1%),治愈率24.5%,總有效率94.9%。54眼葡萄膜炎行玻璃體切除術后痊愈2眼(3.7%),顯效14眼(25.9%),有效30眼(55.6%),無效8眼(14.8%),治愈率3.7%,總有效率85.2%。本組病例治療前后視力相比有差別,其差別有統(tǒng)計學意義(P0.01)；本組病例治療前、后眼部體征相比有差別,其差別有統(tǒng)計學意義(P0.01)。本組病例治療前后的并發(fā)癥發(fā)生情況相比有差別,其差別有統(tǒng)計學意義(P0.01)；不同性別、年齡、病因、病程的患者行玻璃體切除術后臨床療效無明顯差別,其差別無統(tǒng)計學意義(P0.05)不同解剖分類的患者行玻璃體切除術后臨床療效有差別,其差別有統(tǒng)計學意義(P0.05)；不同復發(fā)次數(shù)的患者行玻璃體切除術后臨床療效有差別,其差別有統(tǒng)計學意義(P0.01)。結論：葡萄膜炎仍是眼科常見致盲性疾病,好發(fā)于青壯年,男性多于女性,病因多樣化,發(fā)病機制復雜,以特發(fā)性葡萄膜炎為主,以急性葡萄膜炎和前葡萄膜炎分布居多。目前仍以藥物治療為主,但針對一部分單純藥物治療無效且反復發(fā)作、遷延不愈的葡萄膜炎行玻璃體切除術也有一定的臨床療效,其不同的解剖分類、復發(fā)次數(shù)將影響玻璃體切除術后的臨床療效。
[Abstract]:Objective: to investigate the clinical characteristics of uveitis and the factors influencing the clinical efficacy of vitrectomy in the treatment of uveitis. Methods: from January 2004 to December 2009 in Urumqi General Hospital of Lanzhou military region, various types of ophthalmological treatment were studied. The clinical data of 216 eyes of 184 patients with uveitis were retrospectively analyzed. Age, etiology, course of disease, anatomical classification, number of recurrence, treatment, changes of visual acuity and ocular signs before and after treatment, occurrence of complications. The changes of ocular signs and the occurrence of complications were analyzed statistically. According to the changes of visual acuity, ocular signs and complications before and after treatment, the clinical efficacy was evaluated. 48 cases (54 eyes) of uveitis underwent vitrectomy. The effects of sex, age, etiology, course of disease, anatomic classification and recurrence frequency on the clinical efficacy of vitrectomy were compared. Results: there were 184 cases (216 eyes) with various uveitis, 142 cases (164 eyes) were male, 42 cases (52 eyes) were female. 100 cases (54.3%) were mostly from 21 to 40 years old. Etiology: 103 cases (56.0%) were mainly idiopathic uveitis) the next was traumatic uveitis (23 cases) 12.5%. Course of disease: 155 eyes with acute uveitis, 71.8% with chronic uveitis; 61 cases with chronic uveitis. Anatomical classification: 136 eyes (63.0 eyes) were mainly uveitis before, followed by 61 eyes (28.2m) with total uveitis. Recurrence times: the number of previous recurrence in the hospital was 0 times (163 eyes) 75.5o 0 times (20 eyes) with 9.23-4 times (28 eyes) 13.00 times and above (5 times). Treatment: 154 eyes were treated with drugs alone, 62 eyes were treated with combined drug surgery, 54 eyes were treated with vitrectomy. Complications: 81 eyes had no complications before treatment, 135 eyes had complications. A total of 144 eyes (66.7 eyes) had complications and 72 eyes (33.3 eyes) had complications. In this group, 216 eyes (53 eyes) were cured, 53 eyes (24. 5%) were cured, 83 eyes (38. 5%) were effective, 69 eyes (31. 995%) were effective, 11 eyes (11 eyes) were not effective, the cure rate was 24.55.The total effective rate was 94.9.54 eyes, 2 eyes were cured after vitrectomy, and 14 eyes showed remarkable effect. The curative rate was 3.7and the total effective rate was 85.2. The visual acuity of this group of patients was different before and after treatment. There were significant differences in the occurrence of complications before and after treatment in this group of patients (P 0.01) and before and after treatment (P 0.01), and there were significant differences in the occurrence of complications before and after treatment (P 0.01). There was no significant difference in the clinical effect after vitrectomy in patients with age, etiology and course of disease, but there was no significant difference in the clinical efficacy of vitrectomy in patients with different anatomical classification (P 0.05). The difference was statistically significant (P 0.05), the clinical efficacy of patients with different recurrence times after vitrectomy was different, and the difference was statistically significant (P 0.01). Conclusion: uveitis is still a common blinding disease in ophthalmology, which usually occurs in young adults. Male is more than female, the etiology is diverse, the pathogenesis is complicated, mainly idiopathic uveitis, acute uveitis and anterior uveitis are mostly distributed. But there are some clinical effects of vitrectomy for some patients with chronic uveitis. Different anatomical classification and recurrence times will affect the clinical effect after vitrectomy.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R779.6

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