基层医院扶贫白内障复明手术方式与效果分析  

Analysis of the modality and effect of the cataract surgeries in basic level hospital in the poverty alleviation action

作　　者：许道成[1] 罗燕珊[1] 庄曼贤[1] 郭伟如[1] 

机构地区：[1]汕头大学医学院第一附属医院眼科,中国广东省汕头市515041

出　　处：《国际眼科杂志》2008年第6期1173-1175,共3页International Eye Science

摘　　要：目的:比较、分析基层医院扶贫白内障复明手术方式及效果。方法:比较随机选取的2006/2007在基层医院采取现代囊外白内障摘除(extracapsular cataract extraction,ECCE)、大切口(隧道)无缝线白内障(囊外)摘除(sutureless large incision manual cataract extraction,SLIMCE),并人工晶状体(intraocular lens,IOL)植入手术各200例。统计术后视力,术中、术后并发症,手术耗品及费用。结果:术后视力在0.5以上的:ECCE+IOL手术组115例(57.5%),SLIMCE+IOL手术组139例(69.5%);术中后囊膜破裂:ECCE+IOL手术组7例(3.5%),SLIMCE+IOL手术组6例(3.0%);角膜水肿:ECCE+IOL手术组13例(6.5%),SLIMCE+IOL手术组10例(5.0%)。平均每例手术耗品及费用SLIMCE+IOL手术组稍高。结论:在基层医院施行扶贫白内障复明手术,手术要安全、效果要好,手术费用要低,ECCE+IOL植入手术目前还是主要的手术方式。SLIMCE+IOL植入手术采用隧道无缝线切口,操作步骤减少、时间缩短、能够减少术后散光,获得更好的效果,值得提倡。但手术耗费稍增加,对手术操作者的手术技巧要求较高。无论是哪一种手术方式,复明是永恒的主题,需要培养大批有爱心的技术优秀的眼科专业人员,才能使数以百万计的白内障盲患者重见光明。AIM： To analyze and compare the modality and effect of cataract surgeries in basic level hospital in the poverty alleviation action. METHODS： Two hundred cases undergone extracapsular cataract extraction and intraocular lens （ECCE ＋ IOL） , 200 cases taken Sutureless Large Incision Manual Cataract Extraction and intraocular lens （SLIMCE ＋ IOL） were chosen randomly from 2006 to 2007 in basic level hospital. The post-operation vision, complications, matter and price of operation were compared between the ECCE ＋ IOL and SLIMCE ＋ IOL group. RESULTS： After the operation, the visions of 115 cases （57.5%） in ECCE ＋ IOL group and 139 cases （69.5%） in SLIMCE ＋ IOL group were improved above 0.5; 7 cases （3.5%） in ECCE ＋ IOL group and 6 cases （3.0%） in SLIMCE ＋ IOL group were complicated with posteriorcapsule rupture; 13 cases （6. 5%） in ECCE ＋ IOL group and 10 cases in SLIMCE ＋ IOL group were complicated with corneal edema. The SLIMCE ＋ IOL use more matter and cost higher than the ECCE ＋ IOL group. CONCLUSION： The cataract surgeries should be safe, good-effect and low price when enforced in basic level hospital. The ECCE ＋ IOL is still the main modus operandi now. The SLIMCE ＋ IOL has less steps, cost less time and reduce astigmatism after the operation. The SLIMCE ＋ IOL has better effect, is worth to advocate. However, the SLIMCE ＋ IOL cost more and require expert operator. There will be more complications without a seasoned doctor. No matter which modus operandi used, vision rehabilitation is the unaltered objective. A large number of kind and skilled ophthalmology professional staffs are needed to be cultured to make millions of cataract patients to recover their visions.

关 键 词：白内障 手术方式 效果 

分 类 号：R779.66[医药卫生—眼科]