白内障超声乳化吸出术后视网膜中央动脉阻塞风险因素分析  被引量:4

Risk factors of central retinal artery occlusion after phacoemulsification

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作  者:石路漫 雷方[2] 陈彬川[1] 徐一帆[1] 李帅飞[1] 

机构地区:[1]郑州大学第二附属医院眼科,河南省郑州市450014 [2]河南科技大学,河南省洛阳市471023

出  处:《眼科新进展》2016年第11期1047-1050,共4页Recent Advances in Ophthalmology

基  金:郑州市科技局基金资助(编号:121PCXTD523)~~

摘  要:目的探讨白内障超声乳化吸出术后发生视网膜中央动脉阻塞(central retinal artery occlusion,CRAO)的风险因素及相关预后情况。方法本研究为病例对照研究。收集2009年1月至2015年12月在郑州大学第二附属医院眼科行白内障超声乳化吸出术的连续病例8365例,纳入7283例(9100眼),统计CRAO例数7例(即CRAO组),利用随机数列法,以1∶8比例在纳入病例中随机选取56例(56眼)作为对照组,若入选者为CRAO患者则剔除,继续选择。统计白内障核硬度、术前最佳矫正视力、眼压、麻醉方式、术中后囊膜破裂情况、全身疾病等,采用Fisher确切概率法、t检验、Logistic回归等统计学方法分析CRAO的风险因素。结果球后麻醉(风险比3.307,P=0.012)、后囊膜破裂(风险比4.287,P=0.034)是术后CRAO发生的危险因素,高血压、颈动脉斑块患者CRAO发生率与对照组相比差异均有统计学意义(均为P<0.01),是危险因素。而术前最佳矫正视力(≤0.01)、高度近视、青光眼病史、糖尿病病史等差异对于CRAO发生并无统计学意义(均为P>0.05)。结论高血压、颈动脉斑块、球后麻醉及后囊膜破裂均为白内障超声乳化吸出术后CRAO发生的危险因素。Objective To demonstrate the risk factors of the complication central retinal artery occlusion(CRAO) after the cataract surgery of phacoemulsification as well as to find preventions to avoid it. Methods A retrospective study was designed with a total of 7283 cases (9100 eyes) in 8365 patients, which included 7 cases with CRAO ,we selected 56 cases (56 eyes) of patients as control group according to the rato of 1: 8 by random sequence. As if the list was the patient with CRAO,it should be removed. The cataract phacoemulsification was performed in the Second Affiliated Hospital of Zhengzhou University from January 2009 to December 2015. The incidence of CRAO and the risk factors were taken as the main outcomes. The variables of nuclear stages and best correct visual acuity ,intraocuiar pressure and anesthesia methods ,posterior capsular rupture and other diseases were collected and analyzed. Fisher exact probability method, t test, Logistic regression and other statistical methods were performed to analyze risk factors for CRAO. Results Retrobnibar (risk ratio 3. 307,P = 0.012) ,posterior capsular rupture (risk ratio 4. 287 ,P = 0. 034) were risk factors for postoperative CRAO. Hypertension and carotid artery plaque in patients with CRAO incidence were risk factors. Compared with control group, the difference was statistically significant (P 〈 0.01 ). And nuclear hardness grading, preoperative best corrected visual acuity, high myopia, history of glaucoma, diabetes etc. had no statistically difference for CRAO ( all P 〉 0.05 ). Conclusion Hypertension, carotid artery plaques, retrobulbar anesthesia and posterior capsular rupture are the risk factors of CRAO after cataract surgery.

关 键 词:白内障超声乳化吸出术 视网膜中央动脉阻塞 危险因素 

分 类 号:R779.66[医药卫生—眼科]

 

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