湖南师范大学学报（医学版）
湖南師範大學學報（醫學版）
호남사범대학학보（의학판）
JOURNAL OF HUNAN NORMAL UNIVERSITY(MEDICAL SCIENCE)
2013年
2期
74-76
,共3页
原发性闭角型青光眼%超声乳化白内障吸除术%人工晶体植入术%小梁切除术
原髮性閉角型青光眼%超聲乳化白內障吸除術%人工晶體植入術%小樑切除術
원발성폐각형청광안%초성유화백내장흡제술%인공정체식입술%소량절제술
primary angle-closure glaucoma%cataract%phacoemulsifiction%intraocular lens implantation%trabeculectomy
目的：探讨治疗原发性闭角型青光眼伴白内障两种手术方式的适应症、临床疗效及预后。方法：采用非随机临床对照研究方法，拟定手术适应症，对原发性闭角型青光眼伴白内障30眼（27例），进行手术治疗，采用单纯超声乳化白内障吸除+晶体囊内折叠人工晶体植入术（Phaco+IOL）和青-白联合手术（复式小梁切除联合超声乳化白内障吸除+晶体囊内折叠人工晶体植入术（PhacoTrab+IOL），比较不同适应症下两种手术方式初步的临床疗效，随访8~15个月。结果：两组术后随访期内均能将眼压控制在理想范围，术后眼压较术前明显降低，P值<0.05；大部分患者房角较术前增宽，视野增大，前房深度明显加深，二组均未见严重术中并发症。结论：不同手术方式适合不同的病人情况，Phaco+IOL是一种可选用的安全有效的手术方法，能有效提高视力与降低眼压，无术中和术后严重并发症发生；PhacoTrab+IOL则需要患者的眼压情况控制良好，掌握手术时机，操作相对复杂，难度相对较大，但也能取得较好的临床疗效和预后。两种术式的选用要注意适应症的选择。
目的：探討治療原髮性閉角型青光眼伴白內障兩種手術方式的適應癥、臨床療效及預後。方法：採用非隨機臨床對照研究方法，擬定手術適應癥，對原髮性閉角型青光眼伴白內障30眼（27例），進行手術治療，採用單純超聲乳化白內障吸除+晶體囊內摺疊人工晶體植入術（Phaco+IOL）和青-白聯閤手術（複式小樑切除聯閤超聲乳化白內障吸除+晶體囊內摺疊人工晶體植入術（PhacoTrab+IOL），比較不同適應癥下兩種手術方式初步的臨床療效，隨訪8~15箇月。結果：兩組術後隨訪期內均能將眼壓控製在理想範圍，術後眼壓較術前明顯降低，P值<0.05；大部分患者房角較術前增寬，視野增大，前房深度明顯加深，二組均未見嚴重術中併髮癥。結論：不同手術方式適閤不同的病人情況，Phaco+IOL是一種可選用的安全有效的手術方法，能有效提高視力與降低眼壓，無術中和術後嚴重併髮癥髮生；PhacoTrab+IOL則需要患者的眼壓情況控製良好，掌握手術時機，操作相對複雜，難度相對較大，但也能取得較好的臨床療效和預後。兩種術式的選用要註意適應癥的選擇。
목적：탐토치료원발성폐각형청광안반백내장량충수술방식적괄응증、림상료효급예후。방법：채용비수궤림상대조연구방법，의정수술괄응증，대원발성폐각형청광안반백내장30안（27례），진행수술치료，채용단순초성유화백내장흡제+정체낭내절첩인공정체식입술（Phaco+IOL）화청-백연합수술（복식소량절제연합초성유화백내장흡제+정체낭내절첩인공정체식입술（PhacoTrab+IOL），비교불동괄응증하량충수술방식초보적림상료효，수방8~15개월。결과：량조술후수방기내균능장안압공제재이상범위，술후안압교술전명현강저，P치<0.05；대부분환자방각교술전증관，시야증대，전방심도명현가심，이조균미견엄중술중병발증。결론：불동수술방식괄합불동적병인정황，Phaco+IOL시일충가선용적안전유효적수술방법，능유효제고시력여강저안압，무술중화술후엄중병발증발생；PhacoTrab+IOL칙수요환자적안압정황공제량호，장악수술시궤，조작상대복잡，난도상대교대，단야능취득교호적림상료효화예후。량충술식적선용요주의괄응증적선택。
Objective To compare the effeets of two types of surgery on treatment of primary angle-closure glaucoma with cataract. Methods The indications of two types of microsurgery were set up for non-randomized comparison study on 30eyes ( 27cases ) of primary angle-closure glaucoma with cataract patients, who were per-formed phacoemulsification with IOL (Phaco+IOL) and phacortrabeculectomy plus intraocular lens implantation (Phaco Trab+IOL group). The preliminary clinical results of two groups were compared. The follow up visit time was 8~15 months. Results The postoperative IOP in two groups were well controlled postoperatively compared with preoperatively (both P<0.05). The chamber angle was widened and the visual field was increased in most pa-tients of the two groups. No severe intraoperative complications happened in two groups. Conclusion The indica-tions of two types of microsurgery will be benefits for treatment on primary angle-closure glaucoma.with cataract. Phacoemulsification combined with artificial lens implantation for angle-closure glaucoma is safe and effective, which can improve visual acuity and decrease intraocular pressure without inducing severe complications intra and post operation. The glaucoma cataract combined surgery demand the patients have a good condition in the in-traocular pressure and the perfect suitable surgery opportunity, and more the surgery is more complex and hard, but it has good clinical therapeutic effects&prognosis also. The two types of microsurgery must be adopted to in-dications.
