难治性青光眼345例临床分析

发布时间：2018-01-17 20:24

本文关键词：难治性青光眼345例临床分析　出处：《广西医科大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的:通过分析探讨难治性青光眼的病因构成、治疗方案和疗效,为临床预防和治疗提供参考。方法:将345例386只难治性青光眼按病因分为9大类,探讨各自发病机制并统计每种病因比例、治疗和视功能情况。结果:在本研究中难治性青光眼的原发病以外伤性最多,外伤性占45.64%,新生血管性青光眼(neovascular glaucoma, NVG)次之占20.06%,有滤过手术失败史占8.43%,葡萄膜炎性占7.56%,硅油注入术后占6.4%,无晶体眼或人工晶体眼性占5.52%,青少年或发育性占5.52%,视网膜脱离术后占0.58%,玻璃体切除术后占0.29%。治疗方式单行抗青光眼手术占53.89%,单针对病因治疗占25.65%,单行药物治疗占10.62%,病因联合抗青光眼治疗占6.22%,自动出院占2.33%,眼球摘除占1.3%。治疗前平均眼压为42.15±17.68mmHg,经治疗出院平均眼压为14.39±9.03mmaHg。经两样本t检验,P0.05差异有统计学意义,表明经治疗后早期眼压可以得到有效控制。治疗前后视力经比较得出P0.05,表明差异无统计学意义。结论:①难治性青光眼病因构成多样,本次研究位居前三位的分别是眼外伤后继发青光眼45.64%、NVG20.06%、有多次或再次滤过手术失败史青光眼8.43%。②治疗上原发病稳定的以抗青光眼手术为首选,首选方式小梁切除联合MMC,对于手术失败或无法行滤过手术者可行房水引流装置植入术,睫状体破坏手术作为最后考虑。③难治性青光眼经治疗后早期(两周)可以获得满意眼压,远期效果还有待于进一步研究。
[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 卤17.68 mmHg. The mean IOP after treatment was 14.39 卤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.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R775

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