前房穿刺术联合激光周边虹膜成形术治疗急性闭角型青光眼急性发作临床观察  

Observe the clinical effect of acute attack of primary acute angle-closure glaucoma treated by paracentesis of anterior chamber combined with laser peripheral iridoplasty

作　　者：常新奇 孟海林[1] 

机构地区：[1]河南安阳市眼科医院,安阳455000

出　　处：《河南外科学杂志》2013年第2期32-34,共3页Henan Journal of Surgery

摘　　要：目的评价前房穿刺术(ACP)联合激光周边虹膜成形术(LPI)治疗急性闭角型青光眼(AACG)急性发作的实用性和安全性。方法对48例53只眼确诊为急性闭角型青光眼首次急性发作患者非随机分为联合治疗组24例26只眼和药物组24例27只眼,观察治疗后眼压下降情况及眼压下降至21 mm Hg(1 mm Hg=0.133 kPa)所用时间和用药种数、房角开放情况及并发症。结果治疗后0.5、1、2、4、8、12 h眼压分别为:治疗组(10.4±3.8)mm Hg、(11.3±4.1)mm Hg、(11.9±3.6)mm Hg、(16.5±4.6)mm Hg、(17.2±3.3)mm Hg、(16.9±4.4)mm Hg。药物组(40.7±4.4)mm Hg、(36.3±4.8)mm Hg、(25.4±4.8)mm Hg、(18.7±6.6)mm Hg、(20.2±2.9)mm Hg、(17.3±4.1)mm Hg。治疗后0.5、1、2 h组间比较差异具有统计学意义(t=28.392,17.539,8.573。P<0.01)。眼压下降至21 mm Hg所用时间:治疗组30 min内全部降至21 mm Hg以下,药物组为1～12 h,平均6.73 h,组间比较差异具有统计学意义(t=4.635,P<0.05)。眼压下降至21 mm Hg用药种数:治疗组平均(1.15±0.50)种,药物组(3.87±0.33)种,组间比较差异具有统计学意义(t=3.781,P<0.05)。房角开放范围>180°治疗组为88.46%,药物组74.07%,组间比较差异具有统计学意义(x2=17.513,P<0.05)。主要并发症有前房内炎症反应和睫状体脉络膜脱离,无眼内感染和脉络膜上腔驱逐性出血等严重并发症。结论药物降低AACG急性发作时眼压所用时间长。ACP联合LPI治疗迅速安全,无严重并发症,可作为首选治疗措施。Objective To evaluate the practicability and safety between paracentesis of anterior chamber and laser peripheral iridoplasty as an initial treatment for acute attack of primary acute angle -closure glaucoma. Methods 53 eyes （48 cases） with acute primary angle -clo- sure glaucoma were divided into 2 groups ： the union group （26 eyes in 24 cases） were treated with paracentesis of anterior chamber （ACP） combined with laser peripheral iridoplasty （LPI）. And medicine group （27 eyes in 24 cases） were treated with medicine. The post- treatment clinical data including the time of intraocular pressure decreased to 21 mm Hg（ 1 mm Hg = 0. 133 kPa）, the angle of anterior chamber and the complications were Observed Resuhes 0.5h,lh,2h,4h,8h and 12h after treatment,the IOP was reduced to （10.4 ±3.8）ram Hg,（ll.3 ±4.1） mm Hg,（ll.9 ±3.6）mm Hg,（16.5 ±4.6）mm Hg,（17.2 ±3.3）mm Hg,（16.9 ±4.4）mm Hg in union group,and （40.7 ±4.4）mm Hg, （ 36.3 ± 4.8 ） mm Hg, （25.4 ± 4.8 ）mm Hg, （ 18.7 ± 6.6 ） mm Hg, （20.2 ± 2.9 ） mm Hg, （ 17.3 ± 4.1 ） mm Hg in medicine group. There were statistical differences between the two groups about the IOP reduction in 0.5h, l h and 2h（ t =28. 392,17. 539,8. 573 ;P 〈 0.01 ）. In the time of IOP decreased to 21 mm Hg, it was 0.5 h in union group, and 1 - 12h （average 6.73 h） in medicine group. And the differences between the two groups had statistical significance （t = 4. 635,P 〈 0.05 ）. It was （ 1.15 ± 0.50） in union group and （3.87 ± 0.33 ） in medicine group in the numbers of medicine applied. And the differences between the two groups had statistical significance（ t = 3. 781 ,P 〈 0.05 ）. It was 88. 46% in union group and 74.07% in the scope of opening anterior chamber angle 〉 180°. And the differences between the two groups had statistical significance （X^2 = 17.513, P 〈 0.05 ）. The complications were inflammatory reaction in the anterior chamber and cilio - choroidal detachment. There wa

关 键 词：前房穿刺术 激光周边虹膜成形术 急性闭角型青光眼 

分 类 号：R779.6[医药卫生—眼科]