老年性白内障患者术后医疗纠纷的原因分析

发布时间：2018-11-18 18:39

【摘要】：目的分析老年性白内障超声乳化联合人工晶状体(IOL)植入术后发生医疗纠纷的原因。设计回顾性病例系列。研究对象北京同仁医院2012-2016年老年性白内障患者行超声乳化联合IOL植入术后纠纷患者58例。方法对术后纠纷比例、性别、年龄、术眼顺序、投诉主要内容描述及纠纷处理结果进行统计分析。主要指标纠纷比例、纠纷因素。结果 58例患者中51~80岁者50例(86.21%),女性33例(56.90%),双眼均手术者12例(20.69%)。投诉时间在术后4~6个月者41例(70.69%)。角膜水肿、角膜炎致患者术后视物模糊、异物感、磨痛投诉者16例(27.59%),黄斑前膜、黄斑水肿、高度近视致视力不提高或下降者15例(25.86%),玻璃体混浊术后飞蚊加重12例(20.69%),术后IOL下移致重影、眩光、头晕4例(6.90%),术后继发性青光眼3例(5.17%),后囊膜破裂致第一次手术时未植入IOL 1例(1.72%),眼内炎1例(1.72%),术后屈光不正致视近物不清楚1例(1.72%)。结论术后各种视觉不适相关症状及视力不提高是老年性白内障术后纠纷的主要原因,术前应充分与患者沟通及解释。
[Abstract]:Objective to analyze the causes of medical disputes after phacoemulsification combined with intraocular lens (IOL) implantation for senile cataract. Design retrospective case series. Participants 58 patients with senile cataract after phacoemulsification and IOL implantation were enrolled in the study. Methods the proportion of disputes, sex, age, eye order, the main contents of complaints and the results of dispute resolution were analyzed statistically. Main indicators: proportion of disputes, factors of disputes. Results 50 cases (86.21%) were aged 51 to 80 years old, 33 cases (56.90%) were female, 12 cases (20.69%) were bilateral operation. The time of complaint was 4 ~ 6 months after operation in 41 cases (70.69%). Corneal edema, keratitis caused by postoperative blurred vision, foreign body sensation, abrasion pain in 16 cases (27.59%), macular membrane, macular edema, high myopia caused by visual acuity did not improve or decrease in 15 cases (25.86%). After vitreous opacification, 12 cases (20.69%) were aggravated, 4 cases (6.90%) were dizziness, 4 cases (6.90%) were dizziness, 3 cases (5.17%) were secondary glaucoma. IOL was not implanted in 1 case (1.72%), endophthalmitis in 1 case (1.72%) and ametropia in 1 case (1.72%). Conclusion the main causes of postoperative disputes of senile cataract are various symptoms related to visual discomfort and no improvement of visual acuity, which should be fully communicated and explained before operation.
【作者单位】：首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室;首都医科大学附属北京同仁医院医务处;
【分类号】：R197.323;R779.66

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