摘要
目的探讨原发性闭角型青光眼急性发作不同时期行前房穿刺术的效果。方法回顾性分析闭角型青光眼首次急性发作期60例（60眼）按手术时间分为3组：A组20例，手术时间在发病后24h以内；B组20例，发病后1—3d；C组20例，发病后4—7d。术后联合应用药物控制眼压，对3组病例疼痛、眼压、视力、前房角进行比较分析。结果3组间患者的眼压降低幅度比较差异均有统计学意义，A组优于B组（t=3．77，P=0．00），B组优于C组（t=2．85，P=0．01）。3组间患者的疼痛缓解程度、视力提高及前房角开放情况等情况比较A组优于B组（x2=5．63，P=0．03；X2=13．08，P=0．00;x2=10．99，P=0，00），B组优于C组（x2=3．87，P=0．04；Xz=6．05，P=0．04；X2=4．80，P=0．03）。前房穿刺术后又进行其他抗青光眼手术的方式进行比较，差异均有统计学意义，行激光周边虹膜切除术有效者A组多于B组（X2=10．99，P=0．00），B组多于C组（x2=4．80，P=0．03）。结论闭角型青光眼急性发作期越早期行前房穿刺术越能有效地减轻疼痛、控制眼压、恢复视力，并能减少甚至避免行滤过性手术。发作时间超过3d，行前房穿刺术，并未减少须行滤过性手术者。
Objective To evaluate the effect of anterior chamber paracentesis for treating acute at- tack of angle-closure glaucoma in different period. Methods The 60 cases of primary angle-closure glauco- ma in the first acute attacking period were divided into three groups ： group A, n = 20, operation time within 24 hours after the onset, group B, n = 20, operation time in one to three days after the onset, group C, n = 20, operation time in four to seven days after the onset. After paracentesis of anterior chamber, medications were applied to control intraocular pressure （IOP）. The medical records of pain, IOP, vision, anterior chamber angle in three groups were comparatively analyzed. Results The decrease of IOP had significant different between the three groups. The IOP drop value in group A was larger than that in group B （t = 3.77, P = 0. 000 ）, which was higher than that in group C （ t = 2. 85, P = 0. 01 ）. The differences were statis- tically significant in degrees of pain relief, vision improvement, opening of anterior chamber angle among the three groups. The results of group A were better than group B （X2 = 5.63, P = 0. 03 ;X2 = 13.08, P = 0. 00 ;X2 = 10. 99 ,P = 0.00）. The results of group B were better than group C （X： = 3.87 ,P =0, 04 ;X2 = 6. 05 ,P = 0. 04 ;X2 =4. 80,P = 0.03 ）. The differences were statistically significant in the number of the patients who underwent YAG laser peripheral iridotomy in those three groups, the number in group A was larger than group B （X2 = 10. 99,P=0.00）, the number in group B was larger than group C （X2 =4. 80,P =0.03）. Conclusion Paracentesis of anterior chamber on acute attack of angle closure glaucoma can effectively re- lieve pain in early period, control intraocular pressure, restore visual function and can decrease or even a- void the possibilities of glaucoma filtering operation. Anterior chamber paracentesis at more than 3 days after attack will not reduce the possibility of filtering operation.
出处
《中华眼外伤职业眼病杂志》
2013年第7期533-536,共4页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
青光眼
闭角型
发作
急性
眼压
前房穿刺
Glaucoma, angle-closure
Attack, acute
Pressure, intraocular
Paracentesis, anterior chamber
