中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
12期
24-27
,共4页
青光眼,闭角型%白内障%小梁切除术%深巩膜床切除
青光眼,閉角型%白內障%小樑切除術%深鞏膜床切除
청광안,폐각형%백내장%소량절제술%심공막상절제
Glaucoma,angle-closure%Cataract%Trabeculectomy%Deep scleral resection
目的 探讨带深巩膜床切除的改良小梁切除术治疗晚期闭角型青光眼合并白内障的临床疗效及安全性.方法 选择晚期闭角型青光眼合并白内障患者145例(151眼),其中85例(91眼)行带深巩膜床切除的改良小梁切除联合超声乳化人工晶状体植入术(观察组),60例(60眼)行经典小梁切除联合超声乳化人工晶状体植入术(对照组),比较两组术后视力变化、眼压、滤过泡情况及术后并发症.结果 两组术后1个月视力＜0.1、0.4～ 0.5、＞0.5眼数比例与术前比较差异有统计学意义(P＜0.05),0.1～0.3眼数比例与术前比较差异无统计学意义(P＞0.05).两组间术前、术后1个月视力比较差异无统计学意义(P＞0.05).观察组术前眼压为(29.6±4.1) mmHg(1 mmHg=0.133kPa),术后12个月眼压为(13.1±4.9) mmHg,降低幅度为(16.6±5.0) mmHg;对照组术前眼压为(30.4±6.3)mmHg,术后12个月眼压为(18.9±3.0) mmHg,降低幅度为(10.4±4.0) mmHg,两组术后眼压及眼压降低幅度比较差异均有统计学意义(P＜0.05).观察组术后功能性滤过泡(Ⅰ型和Ⅱ型)77眼(84.6％,77/91),对照组为51眼(85.0％,51/60),两组比较差异无统计学意义(P＞0.05).术后1个月内观察组8眼发生一过性低眼压,对照组5眼,两组比较差异无统计学意义(P＞0.05).结论 带深巩膜床切除的改良小梁切除联合手术治疗晚期闭角型青光眼合并白内障较常规方法能更好地降低眼内压,未增加术中风险和术后并发症.
目的 探討帶深鞏膜床切除的改良小樑切除術治療晚期閉角型青光眼閤併白內障的臨床療效及安全性.方法 選擇晚期閉角型青光眼閤併白內障患者145例(151眼),其中85例(91眼)行帶深鞏膜床切除的改良小樑切除聯閤超聲乳化人工晶狀體植入術(觀察組),60例(60眼)行經典小樑切除聯閤超聲乳化人工晶狀體植入術(對照組),比較兩組術後視力變化、眼壓、濾過泡情況及術後併髮癥.結果 兩組術後1箇月視力＜0.1、0.4～ 0.5、＞0.5眼數比例與術前比較差異有統計學意義(P＜0.05),0.1～0.3眼數比例與術前比較差異無統計學意義(P＞0.05).兩組間術前、術後1箇月視力比較差異無統計學意義(P＞0.05).觀察組術前眼壓為(29.6±4.1) mmHg(1 mmHg=0.133kPa),術後12箇月眼壓為(13.1±4.9) mmHg,降低幅度為(16.6±5.0) mmHg;對照組術前眼壓為(30.4±6.3)mmHg,術後12箇月眼壓為(18.9±3.0) mmHg,降低幅度為(10.4±4.0) mmHg,兩組術後眼壓及眼壓降低幅度比較差異均有統計學意義(P＜0.05).觀察組術後功能性濾過泡(Ⅰ型和Ⅱ型)77眼(84.6％,77/91),對照組為51眼(85.0％,51/60),兩組比較差異無統計學意義(P＞0.05).術後1箇月內觀察組8眼髮生一過性低眼壓,對照組5眼,兩組比較差異無統計學意義(P＞0.05).結論 帶深鞏膜床切除的改良小樑切除聯閤手術治療晚期閉角型青光眼閤併白內障較常規方法能更好地降低眼內壓,未增加術中風險和術後併髮癥.
목적 탐토대심공막상절제적개량소량절제술치료만기폐각형청광안합병백내장적림상료효급안전성.방법 선택만기폐각형청광안합병백내장환자145례(151안),기중85례(91안)행대심공막상절제적개량소량절제연합초성유화인공정상체식입술(관찰조),60례(60안)행경전소량절제연합초성유화인공정상체식입술(대조조),비교량조술후시력변화、안압、려과포정황급술후병발증.결과 량조술후1개월시력＜0.1、0.4～ 0.5、＞0.5안수비례여술전비교차이유통계학의의(P＜0.05),0.1～0.3안수비례여술전비교차이무통계학의의(P＞0.05).량조간술전、술후1개월시력비교차이무통계학의의(P＞0.05).관찰조술전안압위(29.6±4.1) mmHg(1 mmHg=0.133kPa),술후12개월안압위(13.1±4.9) mmHg,강저폭도위(16.6±5.0) mmHg;대조조술전안압위(30.4±6.3)mmHg,술후12개월안압위(18.9±3.0) mmHg,강저폭도위(10.4±4.0) mmHg,량조술후안압급안압강저폭도비교차이균유통계학의의(P＜0.05).관찰조술후공능성려과포(Ⅰ형화Ⅱ형)77안(84.6％,77/91),대조조위51안(85.0％,51/60),량조비교차이무통계학의의(P＞0.05).술후1개월내관찰조8안발생일과성저안압,대조조5안,량조비교차이무통계학의의(P＞0.05).결론 대심공막상절제적개량소량절제연합수술치료만기폐각형청광안합병백내장교상규방법능경호지강저안내압,미증가술중풍험화술후병발증.
Objective To compare the feasibility,effectivity and security of modified trabeculectomy in advanced stage angle-close glaucoma with cataract.Methods One hundred and forty-five patients (151 eyes) of advanced stage angle-close glaucoma with cataract were enrolled in this study.Among them,85 patients(91 eyes,observation group) were treated with modified trabeculectomy with the resection of deep scleral resection and 60 patients (60 eyes,control group) were treated with routine trabeculectomy.The visual acuity,intraocular pressure (IOP),type of filtering bleb and postoperative complication were compared.Results There was significant difference in the visual acuity ＜ 0.1,0.4-0.5,＞ 0.5 between after operation for 1 month and before operation in two groups (P ＜ 0.05).but there was no significant difference in the visual acuity 0.1-0.3 (P ＞ 0.05).The IOP before operation in observation group was (29.6 ± 4.1) mmHg (1 mmHg =0.133 kPa),12 months after operation was (13.1 ± 4.9) mmHg,the degree of decrease was (16.6 ± 5.0) mmHg.The IOP before operation in control group was (30.4 ± 6.3) mmHg,12 months after operation was (18.9 ± 3.0) mmHg,the degree of decrease was (10.4 ± 4.0) mmHg.The IOP after operation and the degree of decrease between two groups had significant difference (P ＜ 0.05).The functional filtering bleb(Ⅰ type and Ⅱ type) in observation group was 77 eyes(84.6％,77/91),and 51 eyes(85.0％,51/60) in control group,there was no significant difference (P ＞ 0.05).After operation for 1 month,there was 8 eyes appeared transient hypotony in observation group and 5 eyes in control group,there was no significant difference (P ＞ 0.05).Conclusion The modified trabeculectomy in advanced stage angle-close glaucoma with cataract can reduce IOP more effectively and not increase the intraoperative risk and postoperative complication.
