不同术式治疗梅毒螺旋体感染白内障患者视功能恢复及术后并发症  

Recovery of visual function and postoperative complications in cataract patients with Treponema pallidum infection treated by different surgical methods

作　　者：唐丹燕[1] 邓珍[1] 吴一峰[1] 范芳丽 舒禺杰 TANG Dan-yan;DENG Zhen;WU Yi-feng;FAN Fang-li;SHU Yu-jie(Hangzhou Yuhang District First People's Hospital,Hangzhou,Zhejiang 310000,China)

机构地区：[1]杭州市余杭区第一人民医院眼科,浙江杭州310000

出　　处：《中华医院感染学杂志》2021年第11期1702-1706,共5页Chinese Journal of Nosocomiology

基　　金：浙江省科研基金资助项目(2017TJ769)。

摘　　要：目的对比白内障超声乳化吸出术(Phaco)和现代囊外摘除术(ECCE)治疗梅毒螺旋体感染白内障患者视功能恢复及术后并发症。方法将杭州市余杭区第一人民医院眼科2016年7月-2019年6月收治的96例梅毒螺旋体感染白内障患者作为研究对象,采用简单随机分组法将患者分为Phaco组和ECCE组,各48例。Phaco组行Phaco联合人工晶状体植入治疗,ECCE组行ECCE联合人工晶状体植入治疗,两组术后均随访6个月,对比其术后不同时间点眼压、视力、角膜散光情况及术后并发症发生率。结果两组术后2 h、术后8 h、术后24 h眼压均高于术前(P<0.05),术后48 h眼压与术前比较差异无统计学意义;Phaco组术后2 h、术后8 h、术后24 h眼压均低于ECCE组(P<0.05),术后48 h眼压与ECCE组比较差异无统计学意义(P=0.767)。两组术后1 d、术后7 d、术后1个月、术后3个月和术后6个月视力均高于术前(P<0.05);Phaco组术后7 d视力高于ECCE组(P<0.001),术后1个月、术后3个月和术后6个月视力与ECCE组比较差异均无统计学意义。两组术后7 d、术后1个月角膜散光均高于术前(P<0.05),术后3个月、术后6个月角膜散光与术前比较差异均无统计学意义;Phaco组术后7 d角膜散光低于ECCE组(P=0.017),术后1个月、术后3个月和术后6个月角膜散光均与ECCE组比较差异均无统计学意义。Phaco组术后并发症总发生率低于ECCE组(P=0.031)。结论相较于ECCE,Phaco更能有效促进梅毒螺旋体感染白内障患者术后早期视功能恢复,且可减少术后并发症发生。OBJECTIVE To compare visual function recovery and the incidence of postoperative complications in cataract patients with Treponema pallidum infection(TPI)treated by phacoemulsification(Phaco)and extracapsular cataract extraction(ECCE).METHODS A total of 96 cataract patients with TPI admitted to the Department of Ophthalmology in the First People′s Hospital of Yuhang District,Hangzhou City from Jul.2016 to Jun.2019 were selected as the research subjects,and were divided into Phaco group and ECCE group by simple random grouping method,with 48 cases in each group.The Phaco group was treated with Phaco combined with intraocular lens implantation,while ECCE group was treated with ECCE combined with intraocular lens implantation.Both groups were followed up for 6 months after surgery.The intraocular pressure,visual acuity,corneal astigmatism and the incidence of postoperative complications were compared at different time points after surgery between the two groups.RESULTS The intraocular pressure at 2 h,8 h and 24 h after surgery was significantly higher than that before surgery in the two groups(P<0.05),but there was no significant difference in intraocular pressure at 48 h after surgery compared with that before surgery.At 2 h,8 h and 24 h after surgery,the intraocular pressure of the Phaco group was significantly lower than that of ECCE group(P<0.05).At 48 h after surgery,there was no significant difference in intraocular pressure between the two groups(P=0.767).The visual acuity of the two groups at 1 d,7 d,1 month,3 months and 6 months after surgery was significantly higher than that of preoperative(P<0.05).At 7 d after surgery,the visual acuity at 7 days after the operation in the Phaco group was significantly higher than that in the ECCE group(P<0.001).At 1 month,3 months and 6 months after surgery,there was no significant difference in visual acuity between the two groups.The corneal astigmatism at 7 d and 1 month after surgery in the two groups was significantly higher than that before surgery(P<0.05).At 3 m

关 键 词：白内障超声乳化吸出术 现代囊外摘除 梅毒螺旋体 白内障 视功能 术后并发症 

分 类 号：R776.1[医药卫生—眼科]