负压的多维控制模式及其在白内障超声乳化术中意义  

Clinic meaning of multi-dimensional vacuum control model in phacoemul sification

作　　者：王祥群[1] 何明光[1] 曾骏文[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中国实用眼科杂志》2005年第3期234-237,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的　根据负压在超声乳化手术空间内释放的实际终端效应是具有三维立体分布特征的吸力场 ,本研究在负压的传统脚踏板单维强度 (mmHg ,1mmHg =0 1 33Pa)控制平台的基础上 ,提出融合了基于超声乳化探头控制平台的对负压吸力场强度的空间分布、方向性及阻遏调控的负压多维控制模式 ;就其对提升负压终端效应的精确性及可控性的影响及相关的临床意义进行分析。方法　Ⅳ级硬核老年性白内障病例 1 70例 ( 1 74眼 )接受高负压 ( 2 0 0～ 2 50mmHg)主导下的劈核乳化术式 ,其中 91例 ( 94眼 )接受负压的多维控制模式 ,即在脚踏板控制负压单维强度 (mmHg)的基础上 ,通过调整乳化探头切面的朝向、灌注液流方向及超声靶物的相对位置 ,对负压吸力场进行吸力强度的立体分布、方向性及阻遏调控 ;另外 79例 ( 80眼 )是在传统脚踏板单维负压控制平台下完成的回顾性对照组 ;对术中发生负压相关的后囊膜吸触或吸破的发生阶段以及发生率进行组间差异性对比分析。结果　负压的多维控制模式使负压的实际终端吸力场效应能够更为适时、灵敏地与乳化探头的实际操作状态及操作环境相匹配 ,提升负压的整体控制精度 ,减少负压相关的后囊膜破裂的发生率 ( χ2 =5 4 1 ,P <0 0 2 )。结论　负压的多维控制模式涵盖两个控制平台 :( 1 )Objective According to actual vacuum term in al effect and its 3-dimensional intensity distribution in intraocular space,mult i-dimensional vacuum control model was put forward on the base of simple traditi onal pedal control model,which include controls of 3-dimensional vacuum intensit y distribution and obstruction.Accuracy and contrability of multi-dimensional va cuum control model were evaluated and related clinic meaning were analysed. Methods Induced by high vacuum pressure (200～250mmHg),ha rd nucleus (Grade:Ⅳ) of senile cataract were chopped by chopper before phacoemu lsification in 170 patients (174eyes).91 patients (94 eyes) accepted multi dime nsional vacuum control model,3 dimensional vacuum intensity distribution and ob struction were adjusted by phaco tip on the base of traditional pedal control m odel;another 79 patients (80 eyes) were compared as the simple traditional pedal vacuum control group.The occurrence stages and rates of contact or rupture of p ostcapsular caused by vacuum attraction were compared betweentwo groups. Results The occurrence of contact or rupture of postcapsular caused by vacuum attraction of phaco tip were mainly concentrated on the st age of crushed nucleus phacoemulsification in both groups.Multi dimensional vac uum control model could make the actual terminal vacuum effect cooperate with ph aco operation more precisely and sensitively and protect postcapsular from vacuu m damage(χ 2=5 41, P <0 02). Conclusions Multi dimensional vacuum control model was s et upon the base of traditional vacuum control model.It could maximize the level of cooperation between vacuum actual terminal field and phaco operation and pro tect postcapsular from vacuum damage.

关 键 词：负压 术中 白内障超声乳化术 发生率 回顾性 劈核 对照组 实际 多维 主导 

分 类 号：R776.1[医药卫生—眼科] R779.66[医药卫生—临床医学]