西藏地区白内障手术的安全性及小切口白内障囊外摘出术和超声乳化术的疗效比较  

Safety of cataract surgery and comparison of efficacy of small incision cataract surgery and phacoemulsification in Tibet

作　　者：才瑜[1] 潘英姿[1] 刘晓颖[2] 聂红平[1] 杨松霖[1] 晏晓明[1] 

机构地区：[1]北京大学第一医院眼科,100034 [2]北京大学第一医院麻醉科,100034

出　　处：《眼科研究》2008年第11期852-855,共4页Chinese Ophthalmic Research

摘　　要：目的探讨如何保障西藏地区高血压患者的白内障手术安全,并比较小切口白内障囊外摘出术(SICS)和超声乳化术(PHACO)在西藏地区硬核白内障手术中的效果。方法监测术前、术中血压,对血压超过正常标准者予以药物控制,并观察术后前房出血和全身并发症,比较硬核行SICS和PHACO的术后视力及并发症。结果(1)术前用药后平均收缩压、舒张压和动脉压与用药前比较差异均有统计学意义(P<0.01)。术后前房出血率1.8%(8/452),未出现全身并发症。(2)PHACO组术后与术前视力差与SICS组比较差异无统计学意义(P>0.05)。后囊破裂发生率,PHACO组7.4%(18/242),SICS组5.4%(6/112),二者差异无统计学意义(P>0.05)。虹膜根部解离发生率SICS组7.1%(8/112),较PHACO组0.83%(2/242)高(P=0.035)。角膜水肿分级二者差异无统计学意义(P>0.05)。结论西藏地区白内障患者伴高血压者通过术前术中监测及用药,可降低手术风险,实施白内障手术是安全的。行超声乳化术和小切口白内障囊外摘出术对视力改善无显著影响。Objective Being affected by geographical and climate features,the incidences of cataract,mature cataract and hypertension are higher in Tibet area.Also,the safety of cataract and rehabilitation of visual acuity are different from other parts of China.This study attempted to investigate the safety of cataract patients with hypertension in Tibet and compare the efficacy of small incision cataract surgery （SICS） and phacoemulsification（PHACO） in the cataractous eyes with hard lens in Tibet. Methods The blood pressure of cataract patients was monitored before and intraoperation.The patients with hypertension were managed using medicine.Postoperative hyphema and systematic complications were observed.Visual acuity and ocular complications were analyzed in patients with SICS and PHACO. Results Systolic pressure,diastolic pressure and arterial pressure were all reduced significantly after administration of medicine systemically prior to operation （P〈0.01）.Rate of postoperative hyphema was 1.8% （8/452）.There was no systematic complication was found.Visual acuity difference of postoperation in PHACO eyes（0.97±0.46） was insignificant difference from SICS （0.85±0.43）（P〉0.05）.There was no significant difference between PHACO group （7.4%,18/242） and SICS group（5.4%,6/112） in posterior capsular rapture（P〉0.05）.There was no evidently difference in the grade of corneal edema between two groups （P〉0.05）. Conclusion The procedure of cataract surgery which was preformed in Tibet area is safe in patients with hypertension.The risk factors for operation can be avoided by monitoring blood pressure accompany with use of medicine.There is no significant difference on visual acuity improvement in PHACO and SICS.Either PHACO or SICS can be alternated for better rehabilitation of visual acuity,mainly depending on local economics condition,ophthalmologist’s experience and so on in Tibet area.

关 键 词：西藏 高血压 小切口白内障囊外摘出术 超声乳化术 

分 类 号：R779.66[医药卫生—眼科]