CAJ | 학술논문

目的观察在高眼压下行小切口白内障囊外摘除人工品状体植入联合小梁切除术(简称青白联合术)中前房注射曲安奈德(TA)的有效性和安全性.方法临床病例对照研究.对2009年1月至2012年10月在肇庆医学高等专科学校收集行青白联合术且术前眼压控制不良患者46例(46只眼),按人院时间随机分为二组:实验组(TA组)28例(28只眼)术毕前给以前房内注射曲安奈德混悬液1 mg (0.025 ml)；对照组18例(18只眼)术毕给以球结膜下注射地塞米松2 mg (0.4 ml).观察比较两组术后第1、3、7天前房反应、眼压及角膜内皮水肿情况.结果术后第1、3、7天前房反应(x2值分别为10.97、16.02、7.94)以及眼压(t值分别为3.08、2.78、3.02)实验组明显低于对照组,差异有统计学意义(P＜0.05).角膜内皮水肿情况实验组与对照组比较两者差异无统计学意义(r值分别为2.49、0.11、0.84,P＞0.05).结论 TA抑制高眼压下青白联合术后前房炎症反应效果明显,并且能有效控制术后眼压,对角膜内皮无明显影响,提高了手术成功率.
목적 관찰재고안압하행소절구백내장낭외적제인공품상체식입연합소량절제술(간칭청백연합술)중전방주사곡안내덕(TA)적유효성화안전성.방법 림상병례대조연구.대2009년1월지2012년10월재조경의학고등전과학교수집행청백연합술차술전안압공제불량환자46례(46지안),안인원시간수궤분위이조:실험조(TA조)28례(28지안)술필전급이전방내주사곡안내덕혼현액1 mg (0.025 ml)；대조조18례(18지안)술필급이구결막하주사지새미송2 mg (0.4 ml).관찰비교량조술후제1、3、7천전방반응、안압급각막내피수종정황.결과 술후제1、3、7천전방반응(x2치분별위10.97、16.02、7.94)이급안압(t치분별위3.08、2.78、3.02)실험조명현저우대조조,차이유통계학의의(P＜0.05).각막내피수종정황실험조여대조조비교량자차이무통계학의의(r치분별위2.49、0.11、0.84,P＞0.05).결론 TA억제고안압하청백연합술후전방염증반응효과명현,병차능유효공제술후안압,대각막내피무명현영향,제고료수술성공솔.
Objective To observe the efficacy and safety of injecting triamcinolone acetonide (TA) into the anterior chamber after trabeculectomy combined with cataract extraction and intraocular lens implantation through small tunnel incision under high intraocular pressure.Methods Forty-six cases (46 eyes) with glaucoma and cataract under high intraocular pressure underwent the combination surgery of cataract extraction and trabeculectomy.All cases were randomly divided into two groups:experimental group (TA group),28 cases (28 eyes),received anterior chamber injections of TA lmg (0.025ml) after the combination surgery of cataract extraction and trabeculectomy; control group,18 cases (18 eyes) received subconjunctival injection of dexamethasone 2.5mg after operation.Anterior chamber exudation,intraocular pressure,and the edema of corneal endothelial were observed at 1 day,3 days,7 days after operation.Results Anterior chamber exudation and intraocular pressure in experimental group were less than that of control group (P ＜0.05) and the edema of corneal endothelial was no statistical difference between the two groups at 1 day,3 days,7 days after operation.Conclusions TA is effect to decrease anterior chamber exudation and for cases with glaucoma and cataract under high intraocular pressure underwent the combination surgery of cataract extraction and anti-glaucoma,and after operation at the same time.Injecting TA into the anterior chamber in trabeculectomy with cataract surgery can significantly reduce the postoperative anterior chamber reaction and control the intraocular pressure of postoperative and not affect the corneal endothelium,it can effectively improve the success rate of surgery.