玻璃体切除术后白内障加重的相关因素分析  

Analysis of related factors of cataract aggravation after vitrectomy

作　　者：李元元[1] 陈梦平[1] 冯英策 付蓉花[1] Li Yuanyuan;Chen Mengping;Feng Yingce;Fu Ronghua(Department of Ophthalmology ,Zhengzhou Municipal Second People＇s Hospital,Zhengzhou 450006, Chin)

机构地区：[1]郑州市第二人民医院眼科,郑州450006

出　　处：《中华眼外伤职业眼病杂志》2018年第4期285-288,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的分析玻璃体切除术后引起白内障加重的相关因素。方法2015年6月至2017年6月72例（72眼）患有原发玻璃体积血、视网膜脱离、或玻璃体积血伴视网膜脱离均行玻璃体切除术，术前患者双眼白内障分级均为C1N2P1。手术方式：单纯玻璃体切除术30例、玻璃体切除空气填充22例及玻璃体切除硅油填充20例。手术用时：60min以内完成手术者30例，60～89min者25例，90～150min者17例。年龄：50岁及以上46例，50岁以下26例。所有分组术后比较白内障加重相关因素。结果术后3个月不同手术方式间白内障加重比较无统计学意义（χ2=4．806，P=0．090），术后6个月硅油填充较空气填充和单纯玻璃体切除者更容易加速白内障的发展（χ2=5．775，P=0．016；χ2=14．543，P=0．000），玻璃体切除空气填充与单纯玻璃体切除术比较，差异无统计学意义（χ2=2．145，P=0．143）；手术时间越长，越容易加速白内障的发展，术后3个月和6个月，〈60min完成手术与≥60rain完成手术患者的白内障进展比较差异均有统计学意义（χ2=7．189，P=0．007；χ2=9．914，P=0．002）；年龄越大越容易加速白内障的发展，术后3个月和6个月，50岁及以上患者与50岁以下患者的白内障进展差异均有统计学意义（χ2=4．414，P=0．036；χ2=14．062，P=0．000）。结论玻璃体切除术后白内障加重与手术方式、手术用时及患者年龄均有关系。Objective To analyze the related factors of cataract aggravation after vitrectomy. Methods Seventy-two eyes of 72 patients of vitreous hemorrhage, retinal detachment, or vitreous hemorrhage with retinal detachment underwent vitrectomy. Preoperative cataract grade was CIN2P1. They received different surgical methods ： simple vitrectomy in 30 cases, vitrectomy combined with gas tamponade in 22 cases, vitrectomy combined with silicone tamponade in 20 cases. The operation time of 30 cases was within 60 min, 60-90min in 25 cases,90-150 min in 17 cases. The age of 26 cases was 〈50 years ands〉50 years in 46 cases. The progress of cataract between all the groups in 3 and 6 months was compared. Results The difference of surgical methods was not statistically significant 3 months after surgery （χ2 = 4. 806, P = 0.090 ）. The operation with silicone oil tmnponade was more likely to accelerate the development of cataract 6 months surgery after than the operantion with gas tamponade or vitrectomy （χ2 = 5. 775, P = 0. 016 ;χ2= 14. 543,P =0. 000）. The difference was not statistically significant between vitrectomy combined with gas tamponade and simple vitrectomy （χ2 = 2. 145 P = 0. 143）. The longer of operation time was, the easier the aggravation of cataract was. The difference was statistically significant between surgery time 〈 60 min and ≥ 60 min at 3 and 6 months after surgery（χ2 =7. 189,P =0. 007;χ2 =9. 914, P =0.002）. The older patients were, the easier the aggravation of cataract would be. The difference was statistically significant between age i〉50 years and 〈50 years at 3 and 6 months after operation（χ2 =4. 414,P =0. 036;χ2 = 14. 062, P =O. 000）. Conclusion The aggravation of cataract after vitrectomy is related to operation mode, operation time and age of patient.

关 键 词：玻璃体切除术 白内障 加重 原因 

分 类 号：R779.6[医药卫生—眼科]