地塞米松前房注射对葡萄膜炎并发白内障术后的临床研究

发布时间：2017-12-31 17:24

本文关键词：地塞米松前房注射对葡萄膜炎并发白内障术后的临床研究　出处：《石河子大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的在手术方式、术前准备、术后处理均相同的情况下，了解葡萄膜炎并发白内障患者行白内障超声乳化+人工晶体植入术，术中前房注射0.1ml地塞米松注射液与前房未注射地塞米松注射液两种不同处理术后炎症反应的差异，并探讨术中前房注射0.1ml地塞米松注射液术后对眼压的影响情况，以及是否引起其它不良反应。方法我院自2011年起葡萄膜炎并发白内障患者行白内障摘除+人工晶体植入术，术中前房注射地塞米松注射液0.1ml。按照病例对照研究，采用回顾性研究的方法将我院近年来葡萄膜炎并发白内障行手术治疗的患者分为两组，如下表所示： A组为对照组：2011年以前，葡萄膜炎并发白内障的患者，行白内障超声乳化联合人工晶体植入术治疗，术中前房未注射地塞米松注射液； B组为实验组：2011年以后，葡萄膜炎并发白内障的患者，行白内障超声乳化联合人工晶体植入术治疗，术中前房注射0.1ml地塞米松注射液。两组患者均由同一术者局麻下行小切口白内障超声乳化+人工晶体植入术，B组在手术结束前自手术切口穿刺入前房注入地塞米松注射液0.1ml，前房维持良好，卡米可林缩瞳，封闭切口后，予以球结膜下注射2.5mg地塞米松+2万u妥布霉素，手术结束。A组在手术结束前不做任何特殊处理，前房维持良好，卡米可林缩瞳，封闭切口后，予以球结膜下注射2.5mg地塞米松+2万u妥布霉素，手术结束。两组术中均未出现并发症，术后单眼包扎一日。结果术后前两日对照组与实验组患者视力间差别有统计学意义（P=0.0010.05），且实验组术后患者视力提高病例数所占百分比高于对照组。两组患者术后第一天角膜水肿程度的差异具有统计学意义（P=0.0370.05），前房闪辉差异有统计学意义（P=0.030.05）。两组患者术后前房渗出差异无统计学意义（P=0.0870.05）。两组患者术后眼压差异无统计学意义（P=0.1550.05）。结论葡萄膜炎并发白内障患者行白内障超声乳化+人工晶体植入术，，术中前房注射0.1ml地塞米松者可减轻短期术后反应，改善角膜水肿情况，可更早提高患者视力，减少术后用药次数，不影响术后短期眼压。
[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.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R773.9;R779.66

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