中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
Chinese Journal of Clinicians (Electronic Edition)
2015年
20期
3729-3732
,共4页
青光眼,闭角型%危险因素%抗青光眼手术%恶性青光眼
青光眼,閉角型%危險因素%抗青光眼手術%噁性青光眼
청광안,폐각형%위험인소%항청광안수술%악성청광안
Glaucoma,angle-closure%Risk factors%Glaucoma surgery%Malignant glaucoma
目的：探讨原发性闭角型青光眼术后发生恶性青光眼的危险因素。方法回顾性分析2009年6月至2014年6月727例（939眼）在我院行抗青光眼手术的原发性闭角型青光眼患者的临床资料。其中术后发生恶性青光眼的患者25例（30眼）作为观察组，未发生恶性青光眼患者702例（909眼）作为对照组。记录两组患者的性别、年龄、青光眼类型、术前眼压、前房深度、相对晶状体位置、晶状体厚度、眼轴长度、房角结构及手术方式等临床指标。单因素分析采用卡方检验和t检验，多因素分析采用Logistic回归分析。结果单因素分析结果显示：两组患者在性别、年龄、青光眼类型、术前眼压、前房深度、晶状体厚度、眼轴长度及房角结构方面差异具有统计学意义（P＜0.05），合并症、LOWE系数及手术方式方面比较差异无统计学意义（P＞0.05）。多因素Logistic回归分析结果显示：年龄（OR=3.774，95%CI 1.765～7.341，P=0.004）、眼轴长度（OR=2.684，95%CI 1.363～6.953，P=0.005）是原发性闭角型青光眼术后发生恶性青光眼的独立危险因素。结论女性、年龄较轻、慢性闭角型青光眼、术前持续高眼压、房角完全关闭、前房较浅、晶体较薄及眼轴较短的原发性闭角型青光眼患者术后容易发生恶性青光眼，尤其是年龄较轻和眼轴较短的患者，应给予足够的重视。
目的：探討原髮性閉角型青光眼術後髮生噁性青光眼的危險因素。方法迴顧性分析2009年6月至2014年6月727例（939眼）在我院行抗青光眼手術的原髮性閉角型青光眼患者的臨床資料。其中術後髮生噁性青光眼的患者25例（30眼）作為觀察組，未髮生噁性青光眼患者702例（909眼）作為對照組。記錄兩組患者的性彆、年齡、青光眼類型、術前眼壓、前房深度、相對晶狀體位置、晶狀體厚度、眼軸長度、房角結構及手術方式等臨床指標。單因素分析採用卡方檢驗和t檢驗，多因素分析採用Logistic迴歸分析。結果單因素分析結果顯示：兩組患者在性彆、年齡、青光眼類型、術前眼壓、前房深度、晶狀體厚度、眼軸長度及房角結構方麵差異具有統計學意義（P＜0.05），閤併癥、LOWE繫數及手術方式方麵比較差異無統計學意義（P＞0.05）。多因素Logistic迴歸分析結果顯示：年齡（OR=3.774，95%CI 1.765～7.341，P=0.004）、眼軸長度（OR=2.684，95%CI 1.363～6.953，P=0.005）是原髮性閉角型青光眼術後髮生噁性青光眼的獨立危險因素。結論女性、年齡較輕、慢性閉角型青光眼、術前持續高眼壓、房角完全關閉、前房較淺、晶體較薄及眼軸較短的原髮性閉角型青光眼患者術後容易髮生噁性青光眼，尤其是年齡較輕和眼軸較短的患者，應給予足夠的重視。
목적：탐토원발성폐각형청광안술후발생악성청광안적위험인소。방법회고성분석2009년6월지2014년6월727례（939안）재아원행항청광안수술적원발성폐각형청광안환자적림상자료。기중술후발생악성청광안적환자25례（30안）작위관찰조，미발생악성청광안환자702례（909안）작위대조조。기록량조환자적성별、년령、청광안류형、술전안압、전방심도、상대정상체위치、정상체후도、안축장도、방각결구급수술방식등림상지표。단인소분석채용잡방검험화t검험，다인소분석채용Logistic회귀분석。결과단인소분석결과현시：량조환자재성별、년령、청광안류형、술전안압、전방심도、정상체후도、안축장도급방각결구방면차이구유통계학의의（P＜0.05），합병증、LOWE계수급수술방식방면비교차이무통계학의의（P＞0.05）。다인소Logistic회귀분석결과현시：년령（OR=3.774，95%CI 1.765～7.341，P=0.004）、안축장도（OR=2.684，95%CI 1.363～6.953，P=0.005）시원발성폐각형청광안술후발생악성청광안적독립위험인소。결론녀성、년령교경、만성폐각형청광안、술전지속고안압、방각완전관폐、전방교천、정체교박급안축교단적원발성폐각형청광안환자술후용역발생악성청광안，우기시년령교경화안축교단적환자，응급여족구적중시。
Objective To explore the risk factors of malignant glaucoma of primary angle-closure glaucoma post operation. Methods Retrospectively analyzed the clinical data of 727 cases (939 eyes) patients with primary angle-closure glaucoma who received glaucoma surgery from June 2009 to June 2014. 25 cases patients (30 eyes) with malignant glaucoma after surgery were as observation group, 702 cases patients (909 eyes) with no malignant glaucoma after surgery as the control group. Record the gender, age, type of glaucoma, preoperative intraocular pressure, anterior chamber depth, relative position of the lens, lens thickness, length of optic axis, corner structure and operation method of two groups of patients. Single factor analysis used chi-square test and t test, multiple factors analysis used Logistic regression analysis. Results Single factor analysis showed, the gender, age, type of glaucoma, preoperative intraocular pressure and anterior chamber depth, lens thickness, length of optic axis and corner structure of the two groups had statistically significant differences (P<0.05), the complications, LOWE coefficient and operation method of the two groups had no statistically significant differences (P>0.05). Multivariable Logistic regression analysis results showed that age (OR=3.774, 95%CI 1.765-3.774, P=0.004), and length of optic axis (OR=2.684, 95%CI 1.363-6.953, P=0.005) were independent risk factors of primary angle-closure glaucoma post operation. Conclusion Women, younger age, chronic angle-closure glaucoma, continuous high intraocular pressure, corner completely closed, shallow anterior chamber, crystals thinner and shorter optic axis of primary angle-closure glaucoma patients were prone to malignant glaucoma postoperative, especially younger age and optic axis short patients, should be given enough attention.
