本文關(guān)鍵詞：難治性青光眼345例臨床分析　出處：《廣西醫(yī)科大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 難治性青光眼 病因構(gòu)成 預(yù)防 治療

【摘要】： 目的:通過分析探討難治性青光眼的病因構(gòu)成、治療方案和療效,為臨床預(yù)防和治療提供參考。 方法:將345例386只難治性青光眼按病因分為9大類,探討各自發(fā)病機(jī)制并統(tǒng)計(jì)每種病因比例、治療和視功能情況。 結(jié)果:在本研究中難治性青光眼的原發(fā)病以外傷性最多,外傷性占45.64%,新生血管性青光眼(neovascular glaucoma, NVG)次之占20.06%,有濾過手術(shù)失敗史占8.43%,葡萄膜炎性占7.56%,硅油注入術(shù)后占6.4%,無晶體眼或人工晶體眼性占5.52%,青少年或發(fā)育性占5.52%,視網(wǎng)膜脫離術(shù)后占0.58%,玻璃體切除術(shù)后占0.29%。治療方式單行抗青光眼手術(shù)占53.89%,單針對病因治療占25.65%,單行藥物治療占10.62%,病因聯(lián)合抗青光眼治療占6.22%,自動出院占2.33%,眼球摘除占1.3%。治療前平均眼壓為42.15±17.68mmHg,經(jīng)治療出院平均眼壓為14.39±9.03mmaHg。經(jīng)兩樣本t檢驗(yàn),P0.05差異有統(tǒng)計(jì)學(xué)意義,表明經(jīng)治療后早期眼壓可以得到有效控制。治療前后視力經(jīng)比較得出P0.05,表明差異無統(tǒng)計(jì)學(xué)意義。 結(jié)論:①難治性青光眼病因構(gòu)成多樣,本次研究位居前三位的分別是眼外傷后繼發(fā)青光眼45.64%、NVG20.06%、有多次或再次濾過手術(shù)失敗史青光眼8.43%。②治療上原發(fā)病穩(wěn)定的以抗青光眼手術(shù)為首選,首選方式小梁切除聯(lián)合MMC,對于手術(shù)失敗或無法行濾過手術(shù)者可行房水引流裝置植入術(shù),睫狀體破壞手術(shù)作為最后考慮。③難治性青光眼經(jīng)治療后早期(兩周)可以獲得滿意眼壓,遠(yuǎn)期效果還有待于進(jìn)一步研究。
[Abstract]:Objective: to study the etiology, treatment and curative effect of refractory glaucoma, and to provide reference for clinical prevention and treatment. Methods: 386 refractory glaucoma patients in 345 cases were divided into 9 categories according to the etiology. The pathogenesis and the ratio of each etiology, treatment and visual function were analyzed. Results: in this study, the primary disease of refractory glaucoma was the most traumatic, traumatic accounting for 45.64%, neovascular glaucoma neovascular glaucoma. NVG accounted for 20.06%, with a history of failure of filtering operation (8.43%), uveitis (7.56%) and silicone oil injection (6.4%%). Aphakic or intraocular lens was 5. 52%, juvenile or developmental was 5. 52%, retinal detachment accounted for 0.58%. After vitrectomy 0.29%. The treatment method of anti-glaucoma surgery accounted for 53.89%, only for the cause of treatment 25.65, single drug treatment accounted for 10.62%. Etiology combined with anti-glaucoma treatment accounted for 6.22%, automatic discharge was 2.33%, excision of eyeball accounted for 1.3%. The mean IOP before treatment was 42.15 鹵17.68 mmHg. The mean IOP after treatment was 14.39 鹵9.03mmaHg. There was significant difference between the two samples by t test (P0.05). The results showed that the early intraocular pressure could be effectively controlled after treatment, and the visual acuity before and after treatment was obtained by comparison (P0.05), indicating that the difference was not statistically significant. Conclusion the etiology of refractory glaucoma in the study was 45.64% and NVG 20.06% respectively. There is a history of multiple or repeated filtration surgery failure glaucoma 8.43.2 in the treatment of primary stable glaucoma surgery as the first choice, the first choice is trabeculectomy combined with MMC. For those who failed or were unable to perform filtration surgery, the surgery of ciliary body destruction as the final consideration for the treatment of refractory glaucoma can obtain satisfactory intraocular pressure (IOP) early (two weeks) after treatment. The long-term effect remains to be further studied.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R775

【參考文獻(xiàn)】

相關(guān)期刊論文 前6條

1 孫興懷;難治性青光眼的治療[J];國外醫(yī)學(xué).眼科學(xué)分冊;1995年01期

2 滕學(xué)龍;賈志e，

本文編號：1437832