葡萄膜炎并發白內障術中前房注射長效糖皮質激素的療效

李 銳，袁慧敏，劉釗臣，李 勇

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·臨床研究·

葡萄膜炎并發白內障術中前房注射長效糖皮質激素的療效

李 銳，袁慧敏，劉釗臣，李 勇

?METHODS: Clinical data of patients with uveitis complicated cataract who received treatment at our hospital from 2013 to 2015 were analyzed. Patients were divided into two groups by different therapies, Group A: intraoperative injection with triamcinolone, Group B: without treatment of triamcinolone. The near and future curative effect in the two groups patients were compared.

?RESULTS: A total of 68 patients were analyzed, Group A had 35 cases (37 eyes), Group B had 33 cases (34 eyes). Group A patients had a higher rate of patients with a corrected visual acuity more than 0.5 than that of Group B patients (χ2=4.094,P=0.043). There was no significant difference in intraocular pressure between the two groups (P>0.05). Anterior chamber inflammation of the observation group patients were lower than the control group, the difference was statistically significant (χ2=15.900,P=0.001).Seven days after surgery, Group A patients had a higher levels of SOD in aqueous humour and lower levels of MDA and TNF-α in aqueous humour than these of Group B patients (P>0.05). Group A patients had a lower 1 year recurrence rate than that of Group B patients (14%,5/35vs33%,11/33; Log-rankχ2=4.004,P=0.045).

?CONCLUSION: Intraoperative anterior chamber injection with triamcinolone can significantly improve the curative effect in surgical treatment of uveitis complicated cataract.

目的：研究術中前房注射長效糖皮質激素是否能提高葡萄膜炎并發白內障手術的療效，以期為臨床診療提供參考。

方法：分析2013-01/2015-01我院收治的接受手術治療的葡萄膜炎并發白內障患者68例71眼的臨床資料。依據治療方法的不同分為觀察組(術中前房注射曲安奈德，35例37眼)及對照組(術中不注射曲安奈德，33例34眼)。對比兩組患者的療效。

結果:觀察組術后1mo矯正視力>0.5比例顯著高于對照組，差異有統計學意義(χ2=4.094,P=0.043)。兩組術前及術后眼壓比較均無統計學意義(P>0.05)。觀察組患者術后前房炎癥反應低于對照組，差異具有統計學意義(χ2=15.900，P=0.001)；術后1wk，觀察組房水內SOD水平顯著高于對照組，差異有統計學意義(P<0.05)，而MDA及TNF-α水平顯著低于對照組水平，差異有統計學意義(P<0.05)。觀察組術后1a累積復發率顯著低于對照組，差異有統計學意義(14%,5/35vs3%,11/33; Log-rankχ2=4.004,P=0.045)。

結論:術中前房注射曲安奈德可顯著提高葡萄膜炎并發白內障患者手術的療效。

曲安奈德；葡萄膜炎；白內障；手術；復發

引用：李銳，袁慧敏，劉釗臣，等.葡萄膜炎并發白內障術中前房注射長效糖皮質激素的療效.國際眼科雜志2016;16(12):2254-2257

0引言

葡萄膜炎(uveitis)是臨床常見的眼科疾病，其發病機制尚不清楚，可能與感染、遺傳易感及免疫系統疾病有關[1-2]。臨床上葡萄膜炎并發白內障的情況十分常見，可導致嚴重視力障礙，甚至是失明[3]。手術是目前唯一能解除患者視力障礙的方法[4]。但由于患者葡萄膜炎反復發作常存在瞳孔膜閉及虹膜后粘連等情況，這給手術帶來較大操作困難[5-6]。另外，此……