本文選題：惡性青光眼 + 糖尿病��； 參考：《大連醫(yī)科大學(xué)》2010年碩士論文

【摘要】： 目的：回顧性分析不同臨床分型的惡性青光眼病例發(fā)病原因、臨床表現(xiàn)及治療方式,進(jìn)而為惡性青光眼的臨床診斷及治療提供指導(dǎo)。 方法：統(tǒng)計(jì)我院2008年1月至2009年12月住院的患者,病例相對完整的各種原因造成的惡性青光眼5例,記錄該5例(8只眼)惡性青光眼病例的原發(fā)青光眼類型,惡性青光眼的發(fā)病原因和時間,眼壓變化、前房深度,房水閃輝,虹膜位置,晶體厚度,治療及處理措施,UBM、眼科A／B超聲檢查結(jié)果等,對相關(guān)指標(biāo)進(jìn)行分析。 結(jié)果：所有患者均先使用藥物治療2-5天,其中2例3眼睫狀環(huán)阻滯型惡性青光眼好轉(zhuǎn)后出院；其余患者藥物治療無效后,2眼虹膜晶狀體阻滯型惡性青光眼行前房成形術(shù)后好轉(zhuǎn)出院；1眼晶體睫狀體阻滯型青光眼,行白內(nèi)障超聲乳化+人工晶體植入術(shù)后癥狀緩解；1眼因晶體前纖維滲出致惡性青光眼,行前房成形術(shù)+玻璃體穿刺抽液,病情未見好轉(zhuǎn),后行前部玻璃體切割+后囊膜切開術(shù),術(shù)后好轉(zhuǎn)；1眼因眼軸短,惡性青光眼反復(fù)發(fā)作,行調(diào)整縫線,前房注氣,前部玻璃體切割+后囊膜切開術(shù),后緩解出院。 結(jié)論：惡性青光眼的發(fā)病機(jī)制多樣,其治療結(jié)果也參差不齊,我們應(yīng)針對不同的發(fā)病原因,采用相對的治療方式,而不應(yīng)拘束于經(jīng)典惡性青光眼的理解及治療。只要抓住其發(fā)病原因,并進(jìn)行相對直接有效的處理,即能阻斷惡性青光眼的發(fā)病路徑,進(jìn)而緩解病情。在惡性青光眼治療期間,盡量減少不必要的治療措施,以免掩蓋惡性青光眼進(jìn)程或延誤治療時機(jī)。但是行前部玻璃體切割術(shù),建立前房、后房與玻璃體之間的通道是治療各型惡性青光眼成功的關(guān)鍵。
[Abstract]:Objective: to analyze the causes, clinical manifestations and treatment of malignant glaucoma with different clinical types, and to provide guidance for the clinical diagnosis and treatment of malignant glaucoma. Methods: from January 2008 to December 2009, 5 cases of malignant glaucoma caused by various causes were recorded. The primary types of glaucoma were recorded in 5 cases (8 eyes). The cause and time of malignant glaucoma, the change of intraocular pressure, the depth of anterior chamber, the flash of aqueous humor, the iris position, the thickness of lens, the treatment and treatment of UBMand the results of ophthalmology / B ultrasound were analyzed. Results: all the patients were treated with drugs for 2 to 5 days. 2 cases (3 eyes) with ciliary ring block malignant glaucoma were discharged from hospital. 2 eyes of Iris lens block type malignant glaucoma were cured and discharged from hospital by anterior chamber angioplasty after ineffective drug treatment, and 1 eye was treated with ciliary body block glaucoma. After phacoemulsification and intraocular lens implantation, one eye underwent anterior vitrectomy and posterior capsule incision. One eye was treated with adjusting suture, air injection in anterior chamber, posterior capsulorotomy of anterior vitrectomy, and then relieved and discharged because of short axis and recurrent attack of malignant glaucoma. Conclusion: the pathogenesis of malignant glaucoma is diverse and the results of treatment are not uniform. We should adopt relative treatment for different causes and should not be confined to the understanding and treatment of classic malignant glaucoma. As long as we grasp the cause of the disease and deal with it directly and effectively, we can block the path of malignant glaucoma, and then alleviate the disease. During the treatment of malignant glaucoma, minimize unnecessary treatment measures to avoid masking the progress of malignant glaucoma or delay the time of treatment. However, anterior vitrectomy and the establishment of anterior chamber, posterior chamber and vitreous channel are the key to successful treatment of various types of malignant glaucoma.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R775

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本文編號：1908580