超聲乳化聯(lián)合人工晶體植入術(shù)對外傷性晶體半脫位的療效觀察

趙偉

【摘要】 目的：探究外傷性晶體半脫位患者在使用超聲乳化聯(lián)合人工晶體植入術(shù)后效果。方法：研究對象為坦桑尼亞桑給巴爾島那茲莫加醫(yī)院眼科中心2015年6月-2017年3月收治的36例（36只眼）外傷性晶體半脫位患者，用隨機排列表法分為觀察組與對照組，18例（18只眼）采用超聲乳化聯(lián)合人工晶體植入術(shù)作為觀察組，另18例（18只眼）采用晶體行囊內(nèi)或囊外摘除及后房型人工晶體鞏膜縫線固定法作為對照組。比較兩組患者實施不同治療對眼壓、視力、并發(fā)癥的影響。結(jié)果：經(jīng)過觀察兩組治療效果可以看出，在眼壓上，術(shù)前兩組比較差異無統(tǒng)計學(xué)意義（t=0.214，P>0.05），觀察組術(shù)后24 h、術(shù)后72 h、術(shù)后1周與對照組相比，眼壓均降低顯著（t=-4.588、-4.997、-6.126，P<0.05）；在視力上，術(shù)前兩組比較差異無統(tǒng)計學(xué)意義（t=-1.177，P>0.05），觀察組術(shù)后24 h、術(shù)后72 h、術(shù)后1周與對照組相比，視力均恢復(fù)顯著較好（t=15.240、16.122、12.944，P<0.05）；且不良反應(yīng)發(fā)生率觀察組（11.11%）顯著比對照組（27.78%）低（ 字2=8.870，P<0.05）。結(jié)論：外傷性晶體半脫位患者在進行超聲乳化聯(lián)合人工晶體植入術(shù)后，能顯著降低不良反應(yīng)發(fā)生率，提升視力恢復(fù)，穩(wěn)定眼壓，此方法值得應(yīng)用與推廣。

【關(guān)鍵詞】 外傷性； 晶體半脫位； 超聲乳化； 人工晶體植入； 治療效果； 并發(fā)癥

Clinical Observation of Ultrasound Phacoemulsification and Intraocular Lens Implantation in the Treatment of Traumatic Lens Subluxation/ZHAO Wei.//Medical Innovation of China，2017，14（32）：140-143

【Abstract】 Objective：To explore the clinical effect of ultrasound phacoemulsification and intraocular lens implantation in the treatment of traumatic lens subluxation.Method：36 patients with traumatic lens subluxation from June 2015 to March 2017 treated in Ophthalmology Department of Abdallah Mzee Hospital，Zanzibar Island，The United Republic of Tanzania were selected.The subjects were randomly divided into the observation group（18 cases，18 eyes） and the control group（18 cases，18 eyes）.The observation group adopted the combined method of ultrasound phacoemulsification and intraocular lens implantation，the control group adopted the intracapsular or extracapsular extraction and transscleral suture fixation of posterior chamber of intraocular lens.After treatment，the intraocular pressure，vision and the incidence rate of complications of two groups were compared.Result：Before surgery，the intraocular pressure of two groups was not significantly different （t=0.214，P>0.05）.After 24 h，72 h and 1 week of surgery，the intraocular pressure of the observation group were significantly lower than those of the control group（t=-4.588，-4.997，-6.126，P<0.05）.Before surgery，the vision of two groups was not significantly different（t=-1.177，P>0.05）.After 24 h，72 h and 1 week of surgery，the visions of the observation group were significantly better than those of the control group（t=15.240，16.122，12.944，P<0.05）.The adverse event rate of the observation group was 11.11%，it was significantly lower than 27.78% of the control group（ 字2=8.870，P<0.05）.Conclusion：For patients with traumatic lens subluxation，the combined method of ultrasound phacoemulsification and intraocular lens implantation can greatly reduce the adverse event rate，improve the recovery of the visions and maintain the intraocular pressure.It is worthy of clinical application and promotion.endprint

【Key words】 Traumatic； Lens subluxation； Ultrasonic phacoemulsification； Intraocular lens implantation； Clinical effect； Complications

First-authors address：Wuxi Peoples Hospital，Wuxi 214023，China

doi：10.3969/j.issn.1674-4985.2017.32.036

鈍挫傷可引起晶狀體全懸韌帶斷裂進而導(dǎo)致外傷性晶狀體脫位，致使晶體發(fā)生渾濁，可使視力發(fā)生嚴重障礙。外傷性晶狀體半脫位患者輕微脫位時，眼壓升高不明顯，自覺癥狀不明顯，易發(fā)生漏診[1]。臨床上一般對其進行手術(shù)治療，但手術(shù)過程過于復(fù)雜。針對患者年齡、晶體核硬度及脫位程度展開不同術(shù)后，由眼外傷引起晶狀體脫位瞳孔區(qū)可能發(fā)生玻璃體疝，應(yīng)及時展開手術(shù)治療[2-3]。現(xiàn)將筆者在援非醫(yī)療期間，坦桑尼亞桑給巴爾島的那茲莫加醫(yī)院眼科中心2015年6月-2017年3月收治的36例（36只眼）外傷性晶體半脫位患者作為研究對象，探討對外傷性晶體半脫位患者實施超聲乳化聯(lián)合人工晶體植入術(shù)治療中的應(yīng)用價值，現(xiàn)報道如下。