不同临床分型恶性青光眼5例治疗方式探讨

发布时间：2018-05-19 03:39

本文选题：恶性青光眼 + 糖尿病　；参考：《大连医科大学》2010年硕士论文

【摘要】： 目的：回顾性分析不同临床分型的恶性青光眼病例发病原因、临床表现及治疗方式,进而为恶性青光眼的临床诊断及治疗提供指导。方法：统计我院2008年1月至2009年12月住院的患者,病例相对完整的各种原因造成的恶性青光眼5例,记录该5例(8只眼)恶性青光眼病例的原发青光眼类型,恶性青光眼的发病原因和时间,眼压变化、前房深度,房水闪辉,虹膜位置,晶体厚度,治疗及处理措施,UBM、眼科A／B超声检查结果等,对相关指标进行分析。结果：所有患者均先使用药物治疗2-5天,其中2例3眼睫状环阻滞型恶性青光眼好转后出院；其余患者药物治疗无效后,2眼虹膜晶状体阻滞型恶性青光眼行前房成形术后好转出院；1眼晶体睫状体阻滞型青光眼,行白内障超声乳化+人工晶体植入术后症状缓解；1眼因晶体前纤维渗出致恶性青光眼,行前房成形术+玻璃体穿刺抽液,病情未见好转,后行前部玻璃体切割+后囊膜切开术,术后好转；1眼因眼轴短,恶性青光眼反复发作,行调整缝线,前房注气,前部玻璃体切割+后囊膜切开术,后缓解出院。结论：恶性青光眼的发病机制多样,其治疗结果也参差不齐,我们应针对不同的发病原因,采用相对的治疗方式,而不应拘束于经典恶性青光眼的理解及治疗。只要抓住其发病原因,并进行相对直接有效的处理,即能阻断恶性青光眼的发病路径,进而缓解病情。在恶性青光眼治疗期间,尽量减少不必要的治疗措施,以免掩盖恶性青光眼进程或延误治疗时机。但是行前部玻璃体切割术,建立前房、后房与玻璃体之间的通道是治疗各型恶性青光眼成功的关键。
[Abstract]:Objective: to analyze the causes, clinical manifestations and treatment of malignant glaucoma with different clinical types, and to provide guidance for the clinical diagnosis and treatment of malignant glaucoma. Methods: from January 2008 to December 2009, 5 cases of malignant glaucoma caused by various causes were recorded. The primary types of glaucoma were recorded in 5 cases (8 eyes). The cause and time of malignant glaucoma, the change of intraocular pressure, the depth of anterior chamber, the flash of aqueous humor, the iris position, the thickness of lens, the treatment and treatment of UBMand the results of ophthalmology / B ultrasound were analyzed. Results: all the patients were treated with drugs for 2 to 5 days. 2 cases (3 eyes) with ciliary ring block malignant glaucoma were discharged from hospital. 2 eyes of Iris lens block type malignant glaucoma were cured and discharged from hospital by anterior chamber angioplasty after ineffective drug treatment, and 1 eye was treated with ciliary body block glaucoma. After phacoemulsification and intraocular lens implantation, one eye underwent anterior vitrectomy and posterior capsule incision. One eye was treated with adjusting suture, air injection in anterior chamber, posterior capsulorotomy of anterior vitrectomy, and then relieved and discharged because of short axis and recurrent attack of malignant glaucoma. Conclusion: the pathogenesis of malignant glaucoma is diverse and the results of treatment are not uniform. We should adopt relative treatment for different causes and should not be confined to the understanding and treatment of classic malignant glaucoma. As long as we grasp the cause of the disease and deal with it directly and effectively, we can block the path of malignant glaucoma, and then alleviate the disease. During the treatment of malignant glaucoma, minimize unnecessary treatment measures to avoid masking the progress of malignant glaucoma or delay the time of treatment. However, anterior vitrectomy and the establishment of anterior chamber, posterior chamber and vitreous channel are the key to successful treatment of various types of malignant glaucoma.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R775

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