中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2011年
11期
1176-1178
,共3页
青光眼%高眼压%前房穿刺
青光眼%高眼壓%前房穿刺
청광안%고안압%전방천자
Glaucoma%Ocular hypertension%Paracentesis of anterior chamber
目的 探讨前房穿刺放液在处理急性闭角型青光眼急性发作期药物不能控制的高眼压持续状态中的疗效及并发症发生情况.方法 对50例54只眼急性闭角型青光眼急性发作患者在应用常规降眼压药物治疗未能有效降低眼压后,采用26 G B-D注射针头在手术显微镜下进行前房穿刺放液,观察眼压控制以及并发症发生情况.结果 术前眼压均＞50 mm Hg.所有患者经穿刺放液后高眼压及眼痛症状迅速缓解,眼压平均为22 mm Hg.视力均有不同程度的提高.11只眼穿刺后约2～3 h眼压再次升高,遂再次放液.术后20只眼有轻微前房炎性渗出,5只眼有轻度前房出血,4只眼角膜水肿较术前加重,5只眼检查发现轻度视网膜出血.眼压控制后给予相应的手术治疗,术后恢复良好.结论 前房穿刺放液损伤小,反应轻,严重并发症发生率低,是治疗急性闭角型青光眼急性发作期药物不能控制高眼压持续状态的重要辅助措施,为青光眼的进一步治疗创造了条件,并且能够改善预后.
目的 探討前房穿刺放液在處理急性閉角型青光眼急性髮作期藥物不能控製的高眼壓持續狀態中的療效及併髮癥髮生情況.方法 對50例54隻眼急性閉角型青光眼急性髮作患者在應用常規降眼壓藥物治療未能有效降低眼壓後,採用26 G B-D註射針頭在手術顯微鏡下進行前房穿刺放液,觀察眼壓控製以及併髮癥髮生情況.結果 術前眼壓均＞50 mm Hg.所有患者經穿刺放液後高眼壓及眼痛癥狀迅速緩解,眼壓平均為22 mm Hg.視力均有不同程度的提高.11隻眼穿刺後約2～3 h眼壓再次升高,遂再次放液.術後20隻眼有輕微前房炎性滲齣,5隻眼有輕度前房齣血,4隻眼角膜水腫較術前加重,5隻眼檢查髮現輕度視網膜齣血.眼壓控製後給予相應的手術治療,術後恢複良好.結論 前房穿刺放液損傷小,反應輕,嚴重併髮癥髮生率低,是治療急性閉角型青光眼急性髮作期藥物不能控製高眼壓持續狀態的重要輔助措施,為青光眼的進一步治療創造瞭條件,併且能夠改善預後.
목적 탐토전방천자방액재처리급성폐각형청광안급성발작기약물불능공제적고안압지속상태중적료효급병발증발생정황.방법 대50례54지안급성폐각형청광안급성발작환자재응용상규강안압약물치료미능유효강저안압후,채용26 G B-D주사침두재수술현미경하진행전방천자방액,관찰안압공제이급병발증발생정황.결과 술전안압균＞50 mm Hg.소유환자경천자방액후고안압급안통증상신속완해,안압평균위22 mm Hg.시력균유불동정도적제고.11지안천자후약2～3 h안압재차승고,수재차방액.술후20지안유경미전방염성삼출,5지안유경도전방출혈,4지안각막수종교술전가중,5지안검사발현경도시망막출혈.안압공제후급여상응적수술치료,술후회복량호.결론 전방천자방액손상소,반응경,엄중병발증발생솔저,시치료급성폐각형청광안급성발작기약물불능공제고안압지속상태적중요보조조시,위청광안적진일보치료창조료조건,병차능구개선예후.
Objective To evaluate the efficacy and complications of paracentesis of anterior chamber to treat acute angle-closure glaucoma which couldn't controlled by drugs and with persistent ocular hypertension.Methods Fifty patients (54 eyes) with acute angle-closure glaucoma were received puncture of anterior chamber with a 26G BD under a microscope when the medicine therapy couldn't.lower intraocular pressure.Observe the lOP and complications.Results The mean preoperative intraocular pressure was over 50 mmHg.All patients' high intraocular pressure and eye pain were relief immediately after the puncture of anterior chamber.The average intraocular pressure was 22 mmHg.Vision improved to varying degrees,of which 9 eyes reached 0.3 or more,25 eyes reached 0.1-0.3,20 eyes' vision was counting fingers-＜0.1,11 eyes had intraocular pressure high again and had retreatmeut.Twenty eyes had mild anterior chamber inflammatory exudation,5 eyes had mild hyphema,4cases had corneal edema,5 cases had mild retinal hemorrhage.Conclusions Puncture of anterior chamber can lower the IOP immediately and has little damage and complication.It is an important ongoing adjuvant treatment,which can reduce the patient's suffering by lowering the IOP quickly,reduce the damage of visual function caused by long-term higher intraocular pressure,avoid side effect of the drugs,and can improve the prognosis.
