两种手术方法治疗原发性闭角型青光眼合并白内障的疗效比较  

Comparison of the therapeutic effects of two surgical methods for treating primary angle closure glaucoma ;with cataract

作　　者：包兴旺 

机构地区：[1]浙江省长兴县人民医院眼科,313100

出　　处：《中国基层医药》2017年第3期448-451,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：比较虹膜根切＋小梁切除联合白内障小切口摘除＋人工晶体植入术和虹膜根切＋小梁切除联合白内障超声乳化＋人工晶体植入术两种手术方案的效果，为临床治疗提供依据。方法选择40例原发性闭角型青光眼合并白内障住院患者（68眼）作为研究对象，采用随机数字表法随机分为A、B两组，其中A组19例（31眼），B组21例（37眼），A组患者接受虹膜根切＋小梁切除小切口摘除＋人工晶体植入术治疗，B组患者接受虹膜根切＋小梁切除联合白内障超声乳化＋人工晶体植入术治疗。比较各组患者治疗前后眼压、视力、中央前房深度，以及治疗后两组间眼压、视力、中央前房深度改善量及并发症发生率。结果经治疗后，A组患者眼压、视力以及中央前房深度分别改善（21．71±10．17）mmHg、（0．29±0．09）及（1．97±0.47）mm，改善量具有统计学意义（t值分别为11．12、6．93及17．39，均P＜0．05）；B组患者眼压、视力以及中央前房深度分别改善（19．45±9．54）mmHg、（0．35±0．16）及（1．98±0．39）mm，改善量具有统计学意义（t值分别为6．52、5．78及17．78，均P＜0．05）；治疗后，A、B两组患者眼压分别降低（21．74±10．17）mmHg和（19．45±9.54）mmHg，差异无统计学意义（t＝0．96，P＝0．17）；A、B两组患者视力分别增高（0．29±0．09）度和（0．35±0．16）度，差异无统计学意义（t＝1．86，P＝0．97）；A、B两组患者中央前房深度分别增加（1．97±0．47）mm和（1．98±0．39）mm，差异无统计学意义（t＝0．09，P＝0．54）；A、B两组患者并发症发生率分别为48．39％和21.62％，差异具有统计学意义（χ2＝5．44，P＝0．02）。结论两种手术治疗方案具有良好的、相同的临床效果，但“虹膜根切＋小梁切除联合白内障超声乳化＋人工晶体植入术”术后并发症发生率低Objective To study the different clinical effects between the method of＆quot;peripheral iridectomy＋trabeculectomy combined with cataract extraction with small incision＋intraocular lens implantation＆quot;and the method of＆quot;peripheral iridectomy＋trabeculectomy combined with cataract with phacoemulsification＋intraocular lens implan-tation＆quot;,so as to provide guidance for clinic.Methods 40 cases were randomly divided into A and B groups,and A group included 19 patients （31 eyes）,while B group included 21 patients （37 eyes）.A group was treated with the ＆quot;peripheral iridectomy ＋trabeculectomy combined with cataract extraction with small incision ＋intraocular lens implantation＆quot;method,and B group was cured with the method of＆quot;peripheral iridectomy＋trabeculectomy combined with cataract with phacoemulsification ＋intraocular lens implantation＆quot;method.In each group,the eye pressures, visual acuity,central anterior chamber depths of before and after treatment were compared to study the clinical effect. And after treatment,the improvement amount of eye pressure,visual acuity,central anterior chamber depths and the complication rates were compared between the two groups,so as to determine the better method.Results After treatment,the eye pressure,visual acuity,central anterior chamber depths in A group were significantly improved [（21.71 ±10.17）mmHg,（0.29 ±0.09）and （1.97 ±0.47）mm,t=11.12,6.93,17.39,all P〈0.05].The eye pressure,visual acuity,central anterior chamber depths in B group were significantly improved[（19.45 ±9.54）mmHg, （0.35 ±0.16）and （1.98 ±0.39）mm,t=6.52,5.78,17.78,all P〈0.05].After treatment,the eye pressures in A and B groups were cut down[（21.74 ±10.17）and （19.45 ±9.54）mmHg],and there was no statistical significant difference between the two groups （t=0.96,P=0.17）.The visual acuity in A and B groups were improved[（0.29 ±＆amp;nbsp;0.09）and （0.35 ±0.16）degrees],and there was no statistically s

关 键 词：原发性闭角型青光眼 白内障 小切口摘除 超声乳化 

分 类 号：R779.6[医药卫生—眼科]