CAJ | 학술논문

目的：全面了解四川省乐山地区白内障手术治疗现状,分析调查结果,查找存在的问题,更好地开展白内障防治工作。 　　方法：调查统计2012-01/12乐山市6县1市4个区的17家综合性医院眼科开展白内障手术情况。调查内容：各医院开展白内障手术的相关设备、手术医师、白内障手术情况。根据患者手术经费来源、术式和手术切口不同分成白内障超声乳化及人工晶状体植入1组和2组、白内障囊外摘除及人工晶状体植入1组和2组,分别从患者术前检查、手术医师、手术方式、手术设备、植入人工晶状体类型、手术量、手术效果、术中并发症等方面比较分析。 　　结果：全市拥有相关设备：手术显微镜16台,裂隙灯显微镜43台,非接触式眼压计12台,IOL-Master1台,眼A/B超8台,YAG激光4台,超声乳化仪12台。能独立完成白内障手术医生15人,其中白内障超声乳化手术医生5人。完成白内障总手术量6211眼,其中白内障超声乳化及人工晶状体植入手术3564眼,占总量57%(其中超乳1组为术前视力≥0.3者白内障超声乳化及人工晶状体植入手术1520眼,占总量24%),白内障囊外摘除及人工晶状体植入手术2647眼,占总量43%(囊外1组为防盲白内障囊外摘除及人工晶状体植入手术1533眼,占总量25%)。白内障手术脱盲率94.80%~100%,脱残率90.41%~100%,人工晶状体植入率94.96%~100%,术中并发症率1.00%~15.10%。 　　结论：全市开展白内障手术医师和设备分布不平衡,超乳设备使用率较低,不同级别医院白内障手术技术、手术量和手术效果参差不齐。白内障超声乳化及人工晶状体植入术是主流手术方式,已部分性实现屈光性个性化白内障手术转变。全市白内障手术总体情况较好,但防盲白内障手术比率偏低,手术质量有待进一步提高。
목적：전면료해사천성악산지구백내장수술치료현상,분석조사결과,사조존재적문제,경호지개전백내장방치공작。 　　방법：조사통계2012-01/12악산시6현1시4개구적17가종합성의원안과개전백내장수술정황。조사내용：각의원개전백내장수술적상관설비、수술의사、백내장수술정황。근거환자수술경비래원、술식화수술절구불동분성백내장초성유화급인공정상체식입1조화2조、백내장낭외적제급인공정상체식입1조화2조,분별종환자술전검사、수술의사、수술방식、수술설비、식입인공정상체류형、수술량、수술효과、술중병발증등방면비교분석。 　　결과：전시옹유상관설비：수술현미경16태,렬극등현미경43태,비접촉식안압계12태,IOL-Master1태,안A/B초8태,YAG격광4태,초성유화의12태。능독립완성백내장수술의생15인,기중백내장초성유화수술의생5인。완성백내장총수술량6211안,기중백내장초성유화급인공정상체식입수술3564안,점총량57%(기중초유1조위술전시력≥0.3자백내장초성유화급인공정상체식입수술1520안,점총량24%),백내장낭외적제급인공정상체식입수술2647안,점총량43%(낭외1조위방맹백내장낭외적제급인공정상체식입수술1533안,점총량25%)。백내장수술탈맹솔94.80%~100%,탈잔솔90.41%~100%,인공정상체식입솔94.96%~100%,술중병발증솔1.00%~15.10%。 　　결론：전시개전백내장수술의사화설비분포불평형,초유설비사용솔교저,불동급별의원백내장수술기술、수술량화수술효과삼차불제。백내장초성유화급인공정상체식입술시주류수술방식,이부분성실현굴광성개성화백내장수술전변。전시백내장수술총체정황교호,단방맹백내장수술비솔편저,수술질량유대진일보제고。
AIM: To comprehensively investigate the current status of cataract surgery in Leshan city, and find the existing problems according to the survey results as a guide to cataract prevention and treatment in future. METHODS: We surveyed the status of cataract surgery containing equipments, surgeons and surgery conditions in 17 ophthalmology departments of general hospitals from Leshan including 6 counties, 1 county-level city and 4 districts during 2012. Cataract surgery methods, according to various surgery financial resources, surgical performances and surgical incision, were divided into phacoemulsification and intraocular lens implantation ( Phaco + IOL ) , extracapsular cataract extraction and intraocular lens implantation ( ECCE + IOL ) , and each method contained 2 groups. We analyzed the outcomes following preoperative examination, surgeons, surgical methods, surgical equipments, types of IOL, surgical quantity, surgical results, and intraoperative complication. RESULTS: In whole city there were 16 operating microscopes, 43 slit lamp microscopes, 12 non-contact tonometers, 1 intraocular lens Master, 8 optical A/B type ultrasonic examination systems, 4 YAG lasers and 12 phacoemulsification instruments. There 15 doctors could complete cataract surgery independently, and 5 of them were phacoemulsification surgeons. The total number of completed cataract surgeries reached 6 211 eyes, containing 3 564 eyes for Phaco+IOL ( 57%) ( preoperative visual acuity ≥0. 3 in Phaco+IOL1 were 1 520 eyes, 24%) and 2 647 eyes for ECCE+IOL ( 43%) ( 1 533 eyes in ECCE+IOL1, 25%). In various groups, off-blindness rate was 94. 80%-100%, off-disability rate was 90. 41%-100%, and 94. 96% - 100% received intraocular lens implantation, intraoperative complication rate was 1. 00%-15. 10%. CONCLUSION: The distribution of surgeons and equipments in the whole city is unbalanced, and the utilization rate of phaco equipment is low. The levels are different in various hospitals on surgical technique, surgical quantity and surgical results. Phacoemulsification and intraocular lens implantation is considered as the main therapy for cataract, and as a transition to dioptric and personalized cataract surgery. The surgical condition of the city is good, but the proportion of cataract surgery for prevention of blindness in Leshan city is low, and the surgical technique remains to be further improved.