小切口非超声乳化白内障摘除术患者围术期角膜内皮及眼表状态的变化观察
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摘要
目的:探讨小切口非超声乳化白内障摘除术对围术期患者角膜内皮细胞和眼表状态的变化影响。方法:选择本院2015年5月-2017年10月收治的120例(187眼)白内障患者,均行小切口非超声乳化白内障摘除术,于术前和术后1、12 d测量所有患者角膜上部、中央区以及下部的角膜内皮细胞计数,分析患者内皮细胞的密度、丢失率和角膜内皮细胞面积,另统计分析患者眼表状态(泪膜破裂时间、泪液分泌量、角膜染色评分)的变化。结果:角膜上部、中央区、下部角膜内皮细胞密度术后第1天与术前比较均降低,术后12天与治疗第1天比较均升高,角膜内皮细胞面积术后1 d及术后12 d与术前比较均升高,比较差异有统计学意义(P<0.05),各时间点比较差异亦有统计学意义(P<0.05)。治疗第1天角膜不同部位角膜内皮细胞丢失率降低,治疗第12天与第1天比较亦降低,各组时间点比较差异均有统计学意义(P<0.05)。患者眼表状态与治疗前比较均有明显改变,各时间点比较差异均有统计学意义(P<0.05)。结论:小切口非超声乳化白内障摘除术围术期患者角膜内皮细胞的密度降低,角膜的细胞面积扩大,眼表状态改善,临床应用价值更高,患者状态恢复更快。
Objective:To investigate the effect of the changes of perioperative corneal endothelium and ocular inflammatory state of patients with small incision non-phacoemulsification cataract extraction.Method:120 cases(187 eyes)of cataract patients admitted to our hospital from May 2015 to October 2017 were chosen.They were all taken with small incision non-phacoemulsification cataract extraction.The corneal endothelium counts in the upper,central and lower parts of the cornea of all patients were measured before and at 1 and 12 days after surgery.The endothelial cell density,loss rate,and corneal endothelial cell area in patients were analyzed.In addition,the changes of the patients' eye inflammatory status(the tear film rupture time,tear secretion,corneal staining score)were taken for statistics and analysis.Result:The corneal endothelial cell density,corneal endothelial cell density were all reduced 1 day after surgery compared with before surgery,and increased after 12 days of treatment compared with the first day of treatment,the corneal endothelial cell area increased at 1 day and 12 days after treatment,the results were all higher than those at first day before the treatment,the differences were statistical significance between the two groups(P<0.05).There were also with statistical differences at each time point(P<0.05).The loss rate of corneal endothelial cells different parts of the cornea before surgery was lower on the first day of treatment,and the loss rate of endothelial cells was decreased.The 12 th day of treatment was also lower compared with that of the first day of treatment.The differences were statistical significance between the groups at each time point(P<0.05).There were significant improvement in the inflammatory status of the eyes of the patients compared with that before the treatment,the differences of time were with statistical significance(P<0.05).Conclusion:The perioperative period of small incision non-phacoemulsification cataract extraction reduces the density of corneal endothelial cells,enlarges the cell area of the cornea,improves the inflammatory state of the eye,has a low rate of adverse reactions,it is with higher clinical value,and faster patient recovery.
Objective:To investigate the effect of the changes of perioperative corneal endothelium and ocular inflammatory state of patients with small incision non-phacoemulsification cataract extraction.Method:120 cases(187 eyes)of cataract patients admitted to our hospital from May 2015 to October 2017 were chosen.They were all taken with small incision non-phacoemulsification cataract extraction.The corneal endothelium counts in the upper,central and lower parts of the cornea of all patients were measured before and at 1 and 12 days after surgery.The endothelial cell density,loss rate,and corneal endothelial cell area in patients were analyzed.In addition,the changes of the patients' eye inflammatory status(the tear film rupture time,tear secretion,corneal staining score)were taken for statistics and analysis.Result:The corneal endothelial cell density,corneal endothelial cell density were all reduced 1 day after surgery compared with before surgery,and increased after 12 days of treatment compared with the first day of treatment,the corneal endothelial cell area increased at 1 day and 12 days after treatment,the results were all higher than those at first day before the treatment,the differences were statistical significance between the two groups(P<0.05).There were also with statistical differences at each time point(P<0.05).The loss rate of corneal endothelial cells different parts of the cornea before surgery was lower on the first day of treatment,and the loss rate of endothelial cells was decreased.The 12 th day of treatment was also lower compared with that of the first day of treatment.The differences were statistical significance between the groups at each time point(P<0.05).There were significant improvement in the inflammatory status of the eyes of the patients compared with that before the treatment,the differences of time were with statistical significance(P<0.05).Conclusion:The perioperative period of small incision non-phacoemulsification cataract extraction reduces the density of corneal endothelial cells,enlarges the cell area of the cornea,improves the inflammatory state of the eye,has a low rate of adverse reactions,it is with higher clinical value,and faster patient recovery.
引文
[1]韦涛,黄宝辉,何敏.无缝线小切口白内障囊外摘除并晶状体植入术治疗硬核白内障的疗效分析[J].安徽医药,2014,18(4):713-714.
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[3]谢娇,周劲.小切口非超声乳化白内障摘除术对角膜内皮细胞的影响[J].国际眼科杂志,2017,17(9):1756-1758.
[4]管怀进,姚勇,梁从凯,等.江苏省农村50岁及以上人群白内障患病率和手术状况调查[J].中华医学杂志,2013,93(5):330-335.
[5]姜辉.观察小切口非超声乳化白内障摘除术治疗白内障的临床效果[J].中国实用医药,2016,11(22):46-47.
[6]孙铁节.小切口非超声乳化摘除术用于老年白内障治疗的疗效分析[J].中外医学研究,2014,12(27):3-5.
[7]吴柄成,戴红梅,李兰,等.小切口非超声乳化白内障摘除术与超声乳化白内障吸除术的对比[J].国际眼科杂志,2015,15(5):883-886.
[8]李艳秋,胡金桥.改良术式治疗白内障合并青光眼的疗效[J].中国实用医刊,2015,42(9):116-118.
[9]项慧.小切口非超声乳化白内障摘除对白内障膨胀期继发青光眼的治疗作用研究[J].现代诊断与治疗,2017,28(19):3699-3671.
[10]艾则孜·吾买尔,丁汝新,玛依拉·依山.白内障手术方式的研究进展[J].实用临床医药杂志,2016,20(11):218-220.
[11]李永.小梁切除术联合小切口非超声乳化白内障摘除人工晶体植入术疗效观察[J].齐齐哈尔医学院学报,2014,35(3):320-321.
[12]冯桂强.小切口非超声乳化囊外摘除人工晶体植入术治疗白内障的效果观察[J].中国临床新医学,2014,7(2):146-148.
[13]Kim Y K,Kim Y W,Woo S J,et al.Comparison fo surgicallyinduced astigmatism after combined phacoemulsification and23-gauge vitrectomy:2.2-mm vs 2.75-mm cataract surgery[J].Korean J Ophthalmol,2014,28(2):130-137.
[14]刘海凤,杨洋,李艳华,等.两种小切口白内障摘除术在高龄硬核白内障中应用比较[J].中国实用眼科杂志,2014,32(5):570-573.
[15]韩义.超声乳化术治疗对白内障患者角膜内皮细胞及泪液炎性指标的影响[J].中国实用医药,2017,12(15):38-40.
[16]伍剑锋.小切口非超声乳化白内障摘除人工晶体植入临床分析[J].世界最新医学信息文摘,2015,15(81):71-75.
[17]龚文广,崔红,万基敏.白内障超声乳化与小切口非超声乳化白内障摘除术的临床研究[J].现代诊断与治疗,2015,26(15):3374-3376.
[18]廖茉莉,张大传.不同手术方式治疗白内障患者并发角膜水肿的对照分析[J].中国医疗,2015,50(7):110-112.
[19]张磊,张红,田芳.飞秒激光辅助白内障超声乳化术后角膜内皮细胞丢失率观察[J].中国实用眼科杂志,2014,32(12):1433-1436.
[20]王哲,赵俭江.小切口非超声乳化白内障摘除术核出囊袋的手术体会[J].中国急性医学教育,2015,7(33):152-153.
[2]高云仙,银丽,赵勇.小切口非超声乳化白内障摘除术的临床效果观察[J].中国老年学杂志,2014,15(32):2691-2693.
[3]谢娇,周劲.小切口非超声乳化白内障摘除术对角膜内皮细胞的影响[J].国际眼科杂志,2017,17(9):1756-1758.
[4]管怀进,姚勇,梁从凯,等.江苏省农村50岁及以上人群白内障患病率和手术状况调查[J].中华医学杂志,2013,93(5):330-335.
[5]姜辉.观察小切口非超声乳化白内障摘除术治疗白内障的临床效果[J].中国实用医药,2016,11(22):46-47.
[6]孙铁节.小切口非超声乳化摘除术用于老年白内障治疗的疗效分析[J].中外医学研究,2014,12(27):3-5.
[7]吴柄成,戴红梅,李兰,等.小切口非超声乳化白内障摘除术与超声乳化白内障吸除术的对比[J].国际眼科杂志,2015,15(5):883-886.
[8]李艳秋,胡金桥.改良术式治疗白内障合并青光眼的疗效[J].中国实用医刊,2015,42(9):116-118.
[9]项慧.小切口非超声乳化白内障摘除对白内障膨胀期继发青光眼的治疗作用研究[J].现代诊断与治疗,2017,28(19):3699-3671.
[10]艾则孜·吾买尔,丁汝新,玛依拉·依山.白内障手术方式的研究进展[J].实用临床医药杂志,2016,20(11):218-220.
[11]李永.小梁切除术联合小切口非超声乳化白内障摘除人工晶体植入术疗效观察[J].齐齐哈尔医学院学报,2014,35(3):320-321.
[12]冯桂强.小切口非超声乳化囊外摘除人工晶体植入术治疗白内障的效果观察[J].中国临床新医学,2014,7(2):146-148.
[13]Kim Y K,Kim Y W,Woo S J,et al.Comparison fo surgicallyinduced astigmatism after combined phacoemulsification and23-gauge vitrectomy:2.2-mm vs 2.75-mm cataract surgery[J].Korean J Ophthalmol,2014,28(2):130-137.
[14]刘海凤,杨洋,李艳华,等.两种小切口白内障摘除术在高龄硬核白内障中应用比较[J].中国实用眼科杂志,2014,32(5):570-573.
[15]韩义.超声乳化术治疗对白内障患者角膜内皮细胞及泪液炎性指标的影响[J].中国实用医药,2017,12(15):38-40.
[16]伍剑锋.小切口非超声乳化白内障摘除人工晶体植入临床分析[J].世界最新医学信息文摘,2015,15(81):71-75.
[17]龚文广,崔红,万基敏.白内障超声乳化与小切口非超声乳化白内障摘除术的临床研究[J].现代诊断与治疗,2015,26(15):3374-3376.
[18]廖茉莉,张大传.不同手术方式治疗白内障患者并发角膜水肿的对照分析[J].中国医疗,2015,50(7):110-112.
[19]张磊,张红,田芳.飞秒激光辅助白内障超声乳化术后角膜内皮细胞丢失率观察[J].中国实用眼科杂志,2014,32(12):1433-1436.
[20]王哲,赵俭江.小切口非超声乳化白内障摘除术核出囊袋的手术体会[J].中国急性医学教育,2015,7(33):152-153.