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作 者:施立新 徐金华 杨颖 柏玉洁 夏颖 SHI Lixin;XU Jinhua;YANG Ying;BAI Yujie;XIA Ying(Department of Ophthalmology,Affiliated Hospital,Nanjing University of Chinese Medicine,Nanjing 210029,CHINA)
机构地区:[1]南京中医药大学附属医院眼科,江苏210029
出 处:《江苏医药》2025年第1期75-78,共4页Jiangsu Medical Journal
摘 要:目的 分析行手术治疗的不同眼压状态急性原发性闭角型青光眼(APACG)患者的临床表现。方法 回顾性分析行手术治疗的52例APACG患者的临床资料。经积极降眼压治疗2周后,根据眼压控制情况分为高眼压组(眼压>21mmHg, 21例)和正常眼压组(眼压≤21mmHg, 31例),随后进行手术治疗。记录术前和术后1 d、1周和1个月时的最佳矫正视力(BCVA)、眼压,评估术中数字评定量表(NRS)评分,观察术后前房闪辉渗出和角膜水肿情况。结果 高眼压组结膜充血率高于正常眼压组(P<0.05)。高眼压组术后1 d、1周、1个月BCVA较术前提高(P<0.05);正常眼压组术后1周和1个月BCVA较术前提高(P<0.05)。高眼压组术后1 d、1周、1个月眼压较术前降低(P<0.05);正常眼压组术后眼压与术前相仿(P>0.05)。高眼压组术中NRS评分为(5.57±1.83)分,高于正常眼压组的(3.16±1.00)分(P<0.05)。高眼压组术后前房闪辉渗出和角膜水肿发生率高于正常眼压组[(66.7%vs.19.4%)和(42.8%vs.12.9%)](P<0.05)。结论 不同眼压状态APACG患者具有不同的临床特点。高眼压患者术前结膜充血发生率较高,术中疼痛较重,术后易出现前房闪辉渗出和角膜水肿。Objective To analyze the clinical manifestations of 52 patients with acute primary angle-closure glaucoma(APACG)at different intraocular pressure status undergoing surgery.Methods The clinical data of 52 APACG patients undergoing surgery were retrospectively analyzed.According to intraocular pressure status after actively reducing intraocular pressure treatment,the patients were divided into two groups of A(with intraocular pressure>21 mmHg,21 cases)and B(with intraocular pressure<21 mmHg,31 cases).The best-corrected visual acuity(BCVA)and intraocular pressure were recorded at the time points of before surgery(TO),one day(T1),one week(T2)and one month(T3)after surgery.The intraoperative pain was evaluated by numerical rating scale(NRS)score.The postoperative anterior chamber flash and corneal edema were observed.Results The conjunctival congestion rate was higher in group A than that in group B(P<0.05).The BCVA was higher at T1,T2 and T3 than that at TO in group A(P<0.05).The BCVA was higher at T2 and T3 than that at TO in group B(P<0.05).The intraocular pressure was lower at T1,T2 and T3 than that at TO in group A(P<0.05).The postoperative intraocular pressure in group B was similar to that before operation(P>0.05).The intraoperative NRS score was higher in group A than that in group B[(5.57±1.83)points vs.(3.16±1.00)points](P<0.05).The incidences of postoperative anterior chamber flash and corneal edema were higher in group A than those in group B[(66.7%vs.19.4%)and(42.8%vs.12.9%)](P<0.05).Conclusion APACG patients at different intraocular pressure status have different clinical characteristics.The patients with ocular hypertension have higher incidences of preoperative conjunctival congestion and intraoperative severe pain,and are more prone to occur anterior chamber flash and corneal edema after surgery.
关 键 词:急性原发性闭角型青光眼 眼压
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