摘要
目的分析超声乳化术导致角膜内皮细胞损伤的危险因素,从而为制定白内障患者角膜内皮损伤预防措施提供参考依据。方法以接受超声乳化术治疗的212例白内障患者248只眼睛作为研究对象,采用单因素评价年龄、性别、左/右眼、瞳孔直径、晶状体核硬度分级、超声乳化时间、超声波总能量、灌注液总量与内皮细胞丢失率间的关联,采用多元线性回归分析识别超声乳化术导致角膜内皮细胞损伤的独立危险因素。结果239例患眼术前内皮细胞密度为(2282.4±412.16)个/mm^(2),术后3个月为(1921.77±125.46)个/mm^(2);角膜内皮六角形细胞比例由术前的(54.41±7.22)%降至术后3个月的(45.62±3.58)%(χ^(2)=5.43,P<0.05)。239例患眼角膜内皮细胞损伤发生率15.5%。单因素分析显示,高龄、瞳孔直径较小、超声乳化时间长、晶状体核硬度较高及超声波总能量较高与内皮细胞丢失可能相关;而性别及手术眼睛部位(左眼或右眼)与内皮细胞丢失率不相关。多元线性回归分析显示,晶状体核硬度分级较高、灌注液输注量较大、超声乳化时间长、超声波总能量是内皮细胞丢失率的独立危险因素。结论晶状体核硬度、灌注液输注量、超声乳化时间、超声波总能量是超声乳化术导致内皮细胞丢失的独立危险因素。
Objective To identify the risk factors of corneal endothelial cell injury caused by phacoemulsification,so as to provide the evidence for formulating interventions for prevention of corneal endothelial cell injury among cataract patients.Methods A total 248 eyes from 212 cataract patients that underwent phacoemulsification were selected as study subjects.The associations of subjects’age,gender,left/right eye,pupillary diameter,grades of lens nucleus hardness,duration of phacoemulsification,total ultrasound energy,total infusion fluid amount with endothelial cell loss were evaluated using univariate analysis,and the independent risk factors for corneal endothelial cell injury caused by phacoemulsification were identified using multiple linear regression analysis.Results The density of endothelial cells was(2282.4±412.16)cells/mm^(2)prior to phacoemulsification and(1921.77±125.46)cells/mm^(2)months after phacoemulsification in 239affected eyes,and the proportion of endothelial hexagonal cells was(54.41±7.22)%prior to phacoemulsification and(45.62±3.58)%months after phacoemulsification(χ^(2)=5.43,P<0.05).The incidence of corneal endothelial cell injury was15.5%in 239 affected eyes.Univariate analysis showed that advanced age,small pupillary diameter,long duration of phacoemulsification,high grades of lens nucleus hardness and high total ultrasound energy were associated with endothelial cell loss,while gender and surgical eyes(left or right eye)were not associated with endothelial cell loss.Multiple linear regression analysis revealed that high grades of lens nucleus hardness,high total infusion fluid amount,long duration of phacoemulsification and high total ultrasound energy were independent risk factors for endothelial cell loss.Conclusions Lens nucleus hardness,high totalinfusion fluid amount,long duration of phacoemulsification and high total ultrasound energy are independent risk factors for endothelial cell loss caused by phacoemulsification.
作者
王俊
甘孟欣
黄桦
WANG Jun;GAN Mengxin;HUANG Hua(Department of Ophthalmology,The Second People’s Hospital of Guilin,Guilin 541001 China)
出处
《中国辐射卫生》
2022年第4期498-501,共4页
Chinese Journal of Radiological Health
