高频B超水浴法在化学性眼外伤眼前节观察中的应用  

Diagnostic accuracy of the immersion high-frequency B-scan ultrasonography in chemical injured eyes

作　　者：杨青华[1] 陈兵[1] 王丽强[1] 李朝辉[1] 黄一飞[1] 

机构地区：[1]解放军总医院眼科,北京100853

出　　处：《中华眼科杂志》2014年第8期589-592,共4页Chinese Journal of Ophthalmology

基　　金：国家自然科学基金（81271052、31271059）

摘　　要：目的 评价高频B超水浴法在化学性眼外伤术前观察眼前节结构的准确性.方法 回顾性系列病例研究.收集2011年5月至2013年5月在解放军总医院因化学性眼外伤欲行复明手术的住院患者共63例（63只眼）的临床资料.术前行超声活体显微镜（UBM）和高频B超水浴法对眼前节进行观察,对两者图像进行比较,并以术中对晶状体的诊断为标准,分析其对晶状体的诊断结果.结果 术前成功应用两种超声法对所有63例患者的眼前节结构进行观察.高频B超水浴法对角膜、前房、虹膜、前房角的观察与UBM一致.在对晶状体的观察中,UBM诊断为无晶状体的32例患者中,高频B超水浴法诊断为无晶状体16例,晶状体正常3例,晶状体混浊13例（其中晶状体固缩1例）;UBM诊断为正常晶状体的17例患者中,高频B超水浴法诊断为晶状体正常者14例,其余3例为晶状体膨胀;UBM诊断为疑似晶状体的6例患者中,高频超声水浴法诊断4例晶状体混浊、膨胀、前移,2例晶状体固缩,与术中观察结果相比,高频B超水浴法对晶状体的观察与其高度一致.结论 高频B超水浴法能够准确观察化学性眼外伤眼前节结构,对晶状体的观察准确性优于UBM.Objective To investigate the diagnostic accuracy of the immersion high-frequency B-scan ultrasonography,a noninvasive preoperative diagnosis method,in observing the anterior segment in chemical injured eyes.Methods It was a retrospective study.Sixty-three ocular chemical injury patients （63 eyes）,who accepted the keratoplasty or the artificial cornea transplant in PLA General Hospital from May 2011 to May 2013,were included in this study.All the injured eyes were examined by ultrasound biomicroscopy （UBM） and immersion high-frequency B-scan ultrasonography,respectively.The images were analyzed and the results were compared with the intraoperative findings.The observation of lens was the main parameter.Results All the 63 patients were examined with the UBM and the immersion high-frequency B-scan ultrasonography before the surgery.The findings of the cornea,anterior chamber angle,iris from UBM were consistent with those from the immersion high-frequency B-scan ultrasonography.As for the lens observation,in 32 eyes in which the lens were not detected by UBM,the lens were not detected in only 16 eyes,while 3 eyes with normal lens and 13 eyes with lens pacifications （1 eye with pyknotic lens） by immersion high-frequency B-scan ultrasonography.In 17 eyes in which the lens were found normal by UBM,there were only 14 eyes with normal lens and the rest 3 eyes＇ lens were found intumescent by immersion highfrequency B-scan ultrasonography.In 6 eyes in which lens were detected with suspicious by UBM,2 eyes＇ lens were pyknotic and 4 eyes＇ lens were intumescent or clouded by immersion high-frequency B-scan ultrasonography.The findings of immersion high-frequency B-scan ultrasonography were highly consistent with the intraoperative findings.Conclusions The lens could be observed accurately by immersion high-frequency B-scan ultrasonography in chemical injured eyes.

关 键 词：眼损伤 烧伤 化学 眼前半段 显微镜检查 声学 诊断技术 眼科 

分 类 号：R779.13[医药卫生—眼科]