检验医学与临床
檢驗醫學與臨床
검험의학여림상
JOURNAL OF LABORATORY MEDICINE AND CLINICAL SCIENCES
2009年
15期
1226-1227
,共2页
超声乳化白内障吸除术%人工晶体植入术%角膜内皮损伤
超聲乳化白內障吸除術%人工晶體植入術%角膜內皮損傷
초성유화백내장흡제술%인공정체식입술%각막내피손상
ultrasonic phacoemulsification%intraocular lens implantation%corneal endothelial injury
目的 观察超声乳化白内障吸除术中精确控制超声能量对提高乳化效率,减少角膜内皮损伤并发症的作用.方法 随机抽取行超声乳化白内障吸除联合人工晶体植入术患者50例53眼,对其术前术后角膜内皮细胞情况进行观察.结果 内皮细胞密度为每平方毫米1 500～3 400个,平均每平方毫米(2 075.00±555.47)个,细胞形态均在正常范围内,六边形细胞百分率为(69.98±5.75)%.术后1周角膜内皮细胞密度变化为每平方毫米1 300～3 400个,平均每平方毫米(2 500.00±500.05)个:内皮细胞丢失率为7.92%,手术前后角膜内皮细胞之间的密度差异有统计学意义(P＜0.01).术后角膜内皮细胞形态发生了改变,有轻、重度内皮细胞扩大及多形细胞的增多,并可见空穴.六边形细胞百分率为(53.76±8.26)%,丢失率为15.13%,手术前后的差异有统计学意义(P＜0.01).结论 超声乳化白内障吸除术中对角膜内皮的损伤因素是多方面的,除人工晶体的质量外,还与前房黏弹剂的应用、术中灌注液、手术器械的消毒等有关.手术对角膜内皮的损伤在多环节中发生,手术技巧的提高可明显减少角膜内皮细胞的损伤.
目的 觀察超聲乳化白內障吸除術中精確控製超聲能量對提高乳化效率,減少角膜內皮損傷併髮癥的作用.方法 隨機抽取行超聲乳化白內障吸除聯閤人工晶體植入術患者50例53眼,對其術前術後角膜內皮細胞情況進行觀察.結果 內皮細胞密度為每平方毫米1 500～3 400箇,平均每平方毫米(2 075.00±555.47)箇,細胞形態均在正常範圍內,六邊形細胞百分率為(69.98±5.75)%.術後1週角膜內皮細胞密度變化為每平方毫米1 300～3 400箇,平均每平方毫米(2 500.00±500.05)箇:內皮細胞丟失率為7.92%,手術前後角膜內皮細胞之間的密度差異有統計學意義(P＜0.01).術後角膜內皮細胞形態髮生瞭改變,有輕、重度內皮細胞擴大及多形細胞的增多,併可見空穴.六邊形細胞百分率為(53.76±8.26)%,丟失率為15.13%,手術前後的差異有統計學意義(P＜0.01).結論 超聲乳化白內障吸除術中對角膜內皮的損傷因素是多方麵的,除人工晶體的質量外,還與前房黏彈劑的應用、術中灌註液、手術器械的消毒等有關.手術對角膜內皮的損傷在多環節中髮生,手術技巧的提高可明顯減少角膜內皮細胞的損傷.
목적 관찰초성유화백내장흡제술중정학공제초성능량대제고유화효솔,감소각막내피손상병발증적작용.방법 수궤추취행초성유화백내장흡제연합인공정체식입술환자50례53안,대기술전술후각막내피세포정황진행관찰.결과 내피세포밀도위매평방호미1 500～3 400개,평균매평방호미(2 075.00±555.47)개,세포형태균재정상범위내,륙변형세포백분솔위(69.98±5.75)%.술후1주각막내피세포밀도변화위매평방호미1 300～3 400개,평균매평방호미(2 500.00±500.05)개:내피세포주실솔위7.92%,수술전후각막내피세포지간적밀도차이유통계학의의(P＜0.01).술후각막내피세포형태발생료개변,유경、중도내피세포확대급다형세포적증다,병가견공혈.륙변형세포백분솔위(53.76±8.26)%,주실솔위15.13%,수술전후적차이유통계학의의(P＜0.01).결론 초성유화백내장흡제술중대각막내피적손상인소시다방면적,제인공정체적질량외,환여전방점탄제적응용、술중관주액、수술기계적소독등유관.수술대각막내피적손상재다배절중발생,수술기교적제고가명현감소각막내피세포적손상.
Objective To observe the energy efficiency improvement and the corneal endothelial emulsion injury complications reduced by precise control of intraoperative ultrasound in phacoemulsification and intraovular lens implantation in cataract.Methods Take 53 eyes in 50 cases of patients at random,and their preoperative and postoperative corneal endothelial cells were observed.Results Endothelial cell density of the 53 observed eyes was 1 500-3 400/mm2,with the average of (2 075.00±555.47)/ mm2, cell morphology was in the normal range, and the percentage of hexagonal cells was(69.98 ± 5.75)%. One week after the surgery, the corneal endothelial cell density changes into 1 300-3 400/mm2, with the average of (2 500.00±500.05/mm2:rate of loss of endothelial cell was 7.92%, the difference of the corneal endothelial cell density before and after surgery was significant (P＜0.01). After the surgery, the change of corneal endothelial cell shape has been observed, and the severity of endothelial cells expanded while polymorphonuclear cells increased,and a hole was observed. Hexagon cell percentage was (53.76±8.26)%. The rate of loss was 15.13 %. The statistical analysis before and after surgery was of significant difference (P＜0.01).Conclusion Phacoemulsification operation on the corneal endothelium damage involves in many factors.In addition to the quality of intraocular lens,it is related with the anterior chamber of viscoelastic,the application of intraoperative perfusion fluid and the surgical instrument sterilization.Surgery on the corneal endothelium injury occurred in the multi-link,and the improved surgical techniques could reduce corneal endothelial cell damage.
