针刺在防治老年性白内障术中虹膜松弛综合征的应用研究  

Research of Acupuncture to Prevent and Treat Intraoperative Floppy-Iris Syndrome in Senile Cataract Surgery

作　　者：温积权[1] 洪明胜[1] 陈益丹[2] 徐洁慧[1] 曹永葆[1] WEN Jiquan;HONG Mingsheng;CHEN Yidan;XU Jiehui;CAO Yongbao(Department of Acupuncture and Moxibustion, Zhejiang Hospital, Hangzhou 310013, Zhejiang, China;Department of Ophthalmology, Zhejiang Hospital, Hangzhou 310013, Zhejiang, China)

机构地区：[1]浙江医院眼科,浙江杭州310013 [2]浙江医院针灸科,浙江杭州310013

出　　处：《中华中医药学刊》2018年第6期1503-1506,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省中医药管理局科研基金项目(201722101010487)

摘　　要：目的：探讨针刺防治老年性白内障术中虹膜松弛综合征（IVlS）的应用价值。方法：以医院收治、拟行手术治疗的106例老年白内障单眼患病（纳入标准不用加单眼患病这条，因为老年性白内障往往是双眼发病，住院手术一般都是做一个眼，白内障严重视力差的那个眼手术）患者为研究对象，采用随机数字表分为两组；对照组53例采用常规微切口白内障超声乳化吸除合并人工晶状体植入术进行治疗，观察组53例在术前24、12、2h针灸治疗。分别于手术前后测定瞳孔直径大小、眼压与最佳矫正视力（BCVA），并对比IFIS发生率及对手术的影响，针刺不良反应及手术并发症。结果：治疗前，两组瞳孔直径差异无统计学意义（P〉0．05）；治疗后，观察组瞳孔直径大于对照组，差异有统计学意义（P〈0．05）。观察组IFIS发生率和严重程度低于对照组，组间差异有统计学意义（P〈0．05）。治疗前，两组患者的眼压与BCVA差异无统计学意义（P〉0．05）；治疗后，两组患者的眼压变化不大，BCVA明显改善，且观察组优于对照组（P〈0．05）。观察组手术时间较对照组短，误吸虹膜次数较对照组少，组间差异有统计学意义（P〈0．05）。治疗期间，观察组出现1例针刺部位皮下出血和3例局部疼痛，针刺不良反应发生率为7．55％，术后并发症发生率差异无统计学意义（P〈0．05）。结论：针刺防治老年性白内障术中IFIS疗效确切，安全性高，具有较高的临床推广价值。Objective： To explore the application value of acupuncture to prevent and treat intraoperative floppy - iris syndrome（IFIS） in senile cataract surgery. Methods： A toal of 106 old male patients （106 eyes） with cataract were se- lected and divided into 2 groups, with 53 cases in each. The patients of the control group were treated with mieroincision- al cataract ultrasonic emulsification gettering and intraoeular lens implantation surgery, while patients of the observation group were given acupuncture 24 h, 12 h and 2 h before gettering surgery. The pupil diameter, intraocular pressure and best corrected visual acuity（BCVA） before and after treatment were detected. IFIS occurrence rate and its influence on operation, acupuncture untoward effect and complications were observed. Results： Before treatment, there was no statisti- cal difference in pupil diameter between groups （ P 〉 0.05 ）. After treatment, the observation group＇ s was longer than the that of the control group, and the difference had statistical significance （ P 〈 0. 05 ）. The IFIS occurrence rate and de- gree of the observation group were both lower than those of the control group, and the difference had statistical signifi- cance （ P 〈 0. 05）. The operation time of the observation group was shorter than that of the control group, and the acci- dentally getting iris time of the observation group was less than that of the control group, and the difference had statistical significance（ P 〈 0. 05 ）. The acupuncture untoward effect rate was 7.55% , including 1 case of local bleeding and 3 ca- ses of local pain, and there was no statistical difference in postoperative complications between groups （ P 〉 0. 05 ）. Con- clusion： Acupuncture treatment has definite curative effect and high security, and has high promotional value in clinic.

关 键 词：针刺 白内障 术中虹膜松弛综合征 防治 

分 类 号：R773.1[医药卫生—眼科] R776.1[医药卫生—临床医学]