本文關鍵詞：地塞米松前房注射對葡萄膜炎并發(fā)白內障術后的臨床研究　出處：《石河子大學》2013年碩士論文　論文類型：學位論文

  更多相關文章： 葡萄膜炎 并發(fā)性白內障 地塞米松 前房注射 超聲乳化術

【摘要】：目的 在手術方式、術前準備、術后處理均相同的情況下，了解葡萄膜炎并發(fā)白內障患者行白內障超聲乳化+人工晶體植入術，術中前房注射0.1ml地塞米松注射液與前房未注射地塞米松注射液兩種不同處理術后炎癥反應的差異，并探討術中前房注射0.1ml地塞米松注射液術后對眼壓的影響情況，以及是否引起其它不良反應。 方法 我院自2011年起葡萄膜炎并發(fā)白內障患者行白內障摘除+人工晶體植入術，術中前房注射地塞米松注射液0.1ml。按照病例對照研究，采用回顧性研究的方法將我院近年來葡萄膜炎并發(fā)白內障行手術治療的患者分為兩組，如下表所示： A組為對照組：2011年以前，葡萄膜炎并發(fā)白內障的患者，行白內障超聲乳化聯(lián)合人工晶體植入術治療，術中前房未注射地塞米松注射液； B組為實驗組：2011年以后，葡萄膜炎并發(fā)白內障的患者，行白內障超聲乳化聯(lián)合人工晶體植入術治療，術中前房注射0.1ml地塞米松注射液。 兩組患者均由同一術者局麻下行小切口白內障超聲乳化+人工晶體植入術，B組在手術結束前自手術切口穿刺入前房注入地塞米松注射液0.1ml，前房維持良好，卡米可林縮瞳，封閉切口后，予以球結膜下注射2.5mg地塞米松+2萬u妥布霉素，手術結束。A組在手術結束前不做任何特殊處理，前房維持良好，卡米可林縮瞳，封閉切口后，予以球結膜下注射2.5mg地塞米松+2萬u妥布霉素，手術結束。兩組術中均未出現(xiàn)并發(fā)癥，術后單眼包扎一日。 結果 術后前兩日對照組與實驗組患者視力間差別有統(tǒng)計學意義（P=0.0010.05），且實驗組術后患者視力提高病例數(shù)所占百分比高于對照組。兩組患者術后第一天角膜水腫程度的差異具有統(tǒng)計學意義（P=0.0370.05），前房閃輝差異有統(tǒng)計學意義（P=0.030.05）。兩組患者術后前房滲出差異無統(tǒng)計學意義（P=0.0870.05）。兩組患者術后眼壓差異無統(tǒng)計學意義（P=0.1550.05）。 結論 葡萄膜炎并發(fā)白內障患者行白內障超聲乳化+人工晶體植入術，，術中前房注射0.1ml地塞米松者可減輕短期術后反應，改善角膜水腫情況，可更早提高患者視力，減少術后用藥次數(shù)，不影響術后短期眼壓。
[Abstract]:Purpose Under the same operation mode, preoperative preparation and postoperative treatment, the phacoemulsification and intraocular lens implantation was performed in patients with uveitis complicated with cataract. The difference of postoperative inflammatory reaction between 0.1 ml dexamethasone injection and non-dexamethasone injection in anterior chamber. The effect of 0.1 ml dexamethasone injection in anterior chamber on intraocular pressure and other adverse reactions were investigated. Method Since 2011, cataract extraction and intraocular lens implantation have been performed in patients with uveitis complicated with cataract, and 0.1 ml dexamethasone injection was injected into the anterior chamber during the operation. Patients with uveitis complicated by cataract surgery in our hospital in recent years were divided into two groups by retrospective study, as shown in the following table: Group A was treated with phacoemulsification combined with intraocular lens implantation before 2011, and no dexamethasone injection was injected into anterior chamber during operation. Group B: after 2011, cataract patients complicated with cataract were treated by phacoemulsification combined with intraocular lens implantation, and 0.1 ml dexamethasone injection was injected into anterior chamber during operation. Both groups received phacoemulsification and intraocular lens implantation with small incision under the same local anesthesia. Group B received 0.1 ml dexamethasone injection into the anterior chamber from the incision before the end of the operation. The anterior chamber was maintained well. After closing the incision, 2.5 mg dexamethasone 20,000 u tobramycin was injected under the bulbar conjunctiva. The anterior chamber was maintained well. After closing the incision, 2.5 mg of dexamethasone 20,000 u tobramycin was injected under the bulbar conjunctiva. There were no complications in both groups. Postoperative monocular bandaging was performed on 1st. Results The difference of visual acuity between the control group and the experimental group two days before operation was statistically significant (P < 0.0010.05). The percentage of patients with improved visual acuity in the experimental group was higher than that in the control group. The difference of corneal edema between the two groups on the first day after operation was statistically significant (P < 0.05). There was no significant difference in anterior chamber exudation between the two groups (P < 0.05). There was no significant difference in IOP between the two groups. Conclusion Phacoemulsification and intraocular lens implantation was performed in patients with uveitis complicated with cataract. Injection of 0.1 ml dexamethasone in anterior chamber during the operation could alleviate short-term postoperative reaction and improve corneal edema. It can improve the visual acuity of the patients earlier, reduce the times of postoperative medication, and do not affect the short-term IOP after operation.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R773.9;R779.66

【參考文獻】

相關期刊論文 前10條

1 Mamun-Al Mahtab;Salimur Rahman;Md.Fazal Karim;Mobin Khan;Graham Foster;Susannah Solaiman;Shahrin Afroz;;Epidemiology of hepatitis B virus in Bangladeshi general population[J];Hepatobiliary & Pancreatic Diseases International;2008年06期

2 黃瑞華,王梅芳,汪金方,郁文國;葡萄膜炎并發(fā)性白內障31例的手術治療[J];國際眼科雜志;2005年03期

3 張紅言;朱思泉;;普拉洛芬滴眼液預防白內障術后黃斑囊樣水腫的臨床研究[J];國際眼科雜志;2008年07期

4 陳杰漢;裴育;戴國圣;張勤;;超聲乳化術治療葡萄膜炎并發(fā)白內障的療效觀察[J];國際眼科雜志;2010年02期

5 解孝鋒;郭俊國;畢宏生;李麗麗;;清開靈滴眼液治療慢性葡萄膜炎的臨床觀察[J];國際眼科雜志;2010年06期

6 李文利;李麗波;;葡萄膜炎并發(fā)白內障的手術治療[J];國際眼科雜志;2011年08期

7 余彬,吳靜安;糖皮質激素對保存角膜的影響[J];國外醫(yī)學.眼科學分冊;1990年02期

8 李光達;張曉敏;李筱榮;;實驗性自體免疫性葡萄膜炎的治療研究進展[J];眼科新進展;2011年09期

9 趙靜;張琦;;糖皮質激素性青光眼小梁細胞超微結構的改變[J];眼科學報;2010年02期

10 姜興華,石雁,譚洪,宋玉偉;白內障超聲乳化及人工晶狀體植入術后遲發(fā)性葡萄膜炎的臨床分析[J];眼科研究;2004年06期

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