难治性青光眼345例临床分析  

Clinical analysis of 345 refractory glaucoma cases

作　　者：孙淼[1,2] 刘金华[1] 

机构地区：[1]广西医科大学第一附属医院眼科 [2]湘潭市中心医院眼科,南宁530021

出　　处：《疑难病杂志》2013年第10期776-778,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的分析难治性青光眼病因、治疗方案和疗效，为青光眼临床预防和治疗提供参考。方法选取2003年8月—2011年6月收治的难治性青光眼患者345例386只眼，按病因分为9大类，统计分析不同病因的发病比例、治疗前后视功能和眼压改善情况。结果难治性青光眼患者病因较为复杂，但以外伤性最多（45．79％），新生血管性青光眼次之（20．00％）；与治疗前比较，治疗后患者视力无光感（NIP）、光感（LP）、手动（cF）、指数（HM）、0．01—0．05、0．06—0．10、〉0．10等各级比较差异无统计学意义（P〉0．05）；与治疗前比较，患者治疗后视力变化不明显，但眼压明显降低，差异具有统计学意义（P〈0．05）；治疗方案中以单行抗青光眼手术为主，占53．88％，其次为单针对病因治疗，占25．65％。结论难治性青光眼的发病机制复杂，临床表现不-，治疗应采取综合措施，对视功能损害严重的难治性青光眼应以改善或解除症状为目的。Objective To provide a reference for prevention and treatment of refractory glaucoma, analyze the etiolo- gy, treatment options and efficacy. Methods From August 2003 to June 2011,345 refractory glaucoma patients with 386 eyes in Eye Center of the hospital were enrolled. According to etiology, the patients were divided into nine categories. The inci- dence of different categories, visual function, ocular treatment and treatment options were statistical compared and analysed. Results The etiology of refractory glaucoma patients was very complex. Traumatic was the most common etiology, accounting for 45.79%. The followed was neo-vascular glaucoma, accounting for 20.00%. Compared with before treatment, the NLP, LP,CF, HM, 0.01 -0.05, 0.06 - 0.10, 〉 0.10 of patients after treatment, there were no statistically significant （ P 〉 0.05 ）. Compared with before treatment, after treatment, the patients visual acuity were changed with no significantly diffe- rences, the intraocular pressure were significantly decreased, there were statistically significant （ P 〈 O. 05 ）. The accounted for treatment options of surgery was 53.88%. The accounted for treatment options of categories was 25.65%. Conclusion For the refractory glaucoma patients, the pathogenesis was complex, clinical manifestations varies, so the treatment should be adopt according to comprehensive measures. For serious visual impairment refractory glaucoma patients, the purpose should be improve and relieve the symptoms.

关 键 词：青光眼 难治性 病因 疗效 治疗方案 

分 类 号：R775[医药卫生—眼科]