超声乳化术与囊外摘除术治疗白内障的临床疗效比较  

Comparison of Clinical Efficacy of Phacoemulsification and Extracapsular Extraction for Cataract

作　　者：周琳琳 张德明 周著志 王艳 ZHOU Linlin;ZHANG Deming;ZHOU Zhuzhi;WANG Yan(Department of Ophthalmology,Tongling City Fourth People′s Hospital/Tongling City Maternal and Child Health Care Hospital,Tongling 244000,China)

机构地区：[1]铜陵市第四人民医院铜陵市妇幼保健院眼科,安徽铜陵244000

出　　处：《医学综述》2023年第16期3319-3323,3328,共6页Medical Recapitulate

基　　金：铜陵市卫生和计划生育委员会医学科研项目(卫科研〔2016〕19号)。

摘　　要：目的比较超声乳化术与囊外摘除术治疗白内障的临床疗效。方法选取2018年7月至2022年5月铜陵市妇幼保健院收治的140例白内障患者为研究对象,根据治疗方式不同分为对照组(70例)和观察组(70例)。对照组患者行囊外摘除术,观察组患者行超声乳化术。对比分析两组患者视力、角膜内皮细胞密度(ECD)、变异系数(CV)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、血清25-羟维生素D[25(OH)D]及补体C3水平变化,并对两组患者角膜水肿、玻璃体溢出及虹膜脱出等并发症发生情况进行评价。结果视力组间和时点间的主效应差异有统计学意义(P<0.01),组间和时点间不存在交互作用(P>0.05),观察组患者术后1周视力优于对照组(P<0.05)。ECD、CV组间和时点的主效应差异有统计学意义(P<0.01),组间和时点间存在交互作用(P<0.01),观察组术后1周、术后2周的ECD均高于对照组,CV均低于对照组(P<0.05)。TNF-α、IL-6组间和时点间的主效应差异有统计学意义(P<0.01),组间和时点间存在交互作用(P<0.01),观察组术后1周、术后2周的TNF-α、IL-6均低于对照组(P<0.05)。血清25(OH)D、补体C3组间和时点间的主效应差异有统计学意义(P<0.01),组间和时点间存在交互作用(P<0.01),观察组患者术后1周、术后2周血清25(OH)D、补体C3高于对照组(P<0.05)。观察组总并发症发生率低于对照组[4.29%(3/70)比14.29%(10/70)](χ2=4.155,P=0.042)。结论与囊外摘除术相比,超声乳化术治疗白内障的疗效显著,对角膜内皮细胞的影响较小,术后的炎症应激反应较小,且能够调节血清25(OH)D、补体C3水平,可靠安全。Objective To compare the therapeutic effects of phacoemulsification and extracapsular cataract extraction in the treatment of cataracts.Methods A total of 140 cataract patients admitted to Tongling Maternal and Child Health Hospital from Jul.2018 to May 2022 were included and divided into a control group(70 cases)and an observation group(70 cases)based on different treatment methods.The control group underwent extracapsular cataract extraction surgery,while the observation group underwent phacoemulsification surgery.The changes of visual acuity,corneal endothelial cell density(ECD),coefficient of variation(CV),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),serum 25-hydroxy vitamin D[25(OH)D]and complement C3 levels in the two groups were compared and analyzed.The complications of corneal edema,vitreous overflow and iris prolapse in the two groups were evaluated.Results The main effect difference in visual acuity between groups and time points was statistically significant(P<0.01),and there was no interaction between groups and time points(P>0.05).The visual acuity of the observation group was better than that of the control group one week after surgery(P<0.05).The main effects of ECD and CV were statistically significantly different between groups and time points(P<0.01),and there were interactions between groups and time points(P<0.01).ECD in the observation group was higher than that in the control group one week and two weeks after surgery,and CV was lower than that in the control group(P<0.05).The main effect differences in TNF-αand IL-6 between groups and time points were statistically significant(P<0.01),and there were interactions between groups and time points(P<0.01).The TNF-αand IL-6 levels in the observation group were lower than those in the control group one week and two weeks after surgery(P<0.05).The main effect differences of serum 25(OH)D and complement C3 between groups and time points were statistically significant(P<0.01),and there were interactions between groups and time points(P<0.0

关 键 词：白内障 超声乳化术 囊外摘除术 25-羟维生素D 补体C3 

分 类 号：R779.6[医药卫生—眼科]