小梁切除联合虹膜周切术治疗原发性闭角型青光眼的临床效果  

Clinical effect of trabeculectomy combined with peripheral iridectomy in the treatment of primary angle-closure glaucoma

作　　者：李娜 赵凤琼 杨宇 LI Na;ZHAO Fengqiong;YANG Yu(Department of Ophthalmology,Nanchong Central Hospital&Second Clinical Medical College of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]南充市中心医院&川北医学院第二临床医学院眼科,四川南充637000

出　　处：《贵州医科大学学报》2023年第7期842-847,共6页Journal of Guizhou Medical University

基　　金：2020年四川省卫生健康委员会科研课题(普及应用项目20PJ300)。

摘　　要：目的探讨小梁切除联合虹膜周切术治疗原发性闭角型青光眼患者的临床效果。方法80例原发性闭角型青光眼患者分为对照组(n=40,小梁切除术治疗)和观察组(n=40,小梁切除联合虹膜周切术治疗),收集2组患者住院期间的一般临床资料;于术前及术后1月时,检测2组患者的裸眼视力(UCVA)、眼压(IOP)、中央前房深度(ACD)、周边前房深度(PACD)、眼轴(OA)及前房角(ACA)并计算房角宽度(ACAW);于术前及术后第5天取空腹静脉血,测定2组患者血清白细胞介素1β(IL-1β)、IL-10、超敏C-反应蛋白(hs-CRP)及肿瘤坏死因子α(TNF-α);于术前及术后1月时,采用生活质量综合评定问卷评估2组患者与健康相关的生活质量(物质生活状态、躯体功能、心理功能及社会功能)。结果手术前2组患者UCVA、IOP、ACD、PACD、OA及ACAW比较,差异无统计学意义(P>0.05);手术后1月时观察组患者UCVA、ACD及ACAW高于对照组(P<0.05),IOP低于对照组(P<0.05);手术前2组患者血清IL-1β、IL-10β、hs-CRP及TNF-α炎性因子比较,差异无统计学意义(P>0.05),观察组患者术后1月时血清IL-1β、IL-10β、hs-CRP及TNF-α炎性因子水平低于对照组(P<0.05);观察组患者术后1月时的并发症总发生率(5.0%)低于对照组(22.5%,P<0.05);观察组患者术后1月时的生活质量各维度评分均高于对照组(P<0.05)。结论与单一手术方式相比,小梁切除联合虹膜周切术治疗原发性闭角型青光眼患者的效果较好。Objective To investigate the clinical effect of trabeculectomy combined with peripheral iridectomy in the treatment of primary angle-closure glaucoma patients.Methods 80 patients with primary angle-closure glaucoma were divided into a control group(n=40,treated with trabeculectomy)and an observation group(n=40,treated with trabeculectomy combined with peripheral iridectomy).General clinical data of the two groups of patients during hospitalization were collected.Before operation and one month after operation,the uncorrected visual acuity(UCVA),intraocular pressure(IOP),central anterior chamber depth(ACD),and peripheral anterior chamber depth(PACD),axial length(OA),and anterior chamber angle(ACA)of the patients in the two groups were detected and the anterior chamber angle width(ACAW)was calculated.Before operation and on the 5 th day after operation,fasting venous blood was collected and serum interleukin 1β(IL-1β),interleukin 10(IL-10),hypersensitive C-reactive protein(hs-CRP),and tumor necrosis factorα(TNF-α)of patients in the two groups were measured.Before operation and one month after operation,the health-related quality of life(including material life status,physical function,psychological function and social function)of patients in the two groups was evaluated using the quality of life comprehensive assessment questionnaire.Results Before operation,there was no significant difference in UCVA,IOP,ACD,PACD,OA,and ACAW between the two groups(P>0.05).One month after operation,UCVA,ACD,and ACAW in the observation group were higher than those in the control group(P<0.05),and IOP of the observation group was lower than that of the control group(P<0.05).Before operation,there was no significant difference in serum IL-1β,IL-10β,hs-CRP,and TNF-αinflammatory factors between the two groups(P>0.05),and at one month after operation the levels of serum IL-1β,IL-10β,hs-CRP,and TNF-αinflammatory factors in the observation group were lower than those in the control group(P<0.05).At one month after operation,the to

关 键 词：小梁切除术 青光眼 闭角型 虹膜周切术 原发性闭角型青光眼 眼压 炎性因子 生活质量评分 并发症 

分 类 号：R459.9[医药卫生—治疗学]