摘要
目的探讨原发性闭角型青光眼(PACG)患者小梁切除术后继发恶性青光眼的危险因素,以指导临床。方法回顾性分析2017年6月~2018年12月在我院眼科治疗的140例(120例患眼)PACG患者的临床资料,根据是否继发恶性青光眼,将其分为观察组(继发恶性青光眼,60例,60只患眼)与对照组(未继发恶性青光眼,80例,60只患眼)。比较两组患者的相关资料,记录并分析可能导致患者继发恶性青光眼的因素。结果两组患者的年龄、眼轴长度、晶状体厚度、术前眼压、前房深度、房角结构比较,差异有统计学意义(P<0.05);两组患者的性别、文化程度、家庭人均月收入、合并高血压、糖尿病、冠心病比较,差异无统计学意义(P>0.05)。Logistic回归分析结果显示,年龄≤60岁、术前眼压高、房角完全关闭、眼轴长度<22 mm、晶状体厚度<4.5 mm及前房深度<2 mm均是PACG小梁切除术后继发恶性青光眼的危险因素(OR>1,P<0.05)。结论患者的年龄、术前眼压、房角结构、眼轴长度、晶状体厚度及前房深度等因素均会增加PACG患者发生恶性青光眼的风险,对于该类危险因素的患者,术前应积极对症治疗,以减少术后患者发生恶性青光眼的风险,改善患者疾病预后情况。
Objective To investigate the risk factors of secondary malignant glaucoma after trabeculectomy in patients with primary angle-closure glaucoma(PACG)in order to guide clinical practice.Methods The clinical data of 140 cases of patients with PACG(120 eyes)treated in the ophthalmology department of our hospital from June 2017 to December 2018 were retrospectively analyzed.According to whether secondary malignant glaucoma occurred,the patients were divided into observation group(n=60,60 eyes with secondary malignant glaucoma)and control group(n=80,60 eyes without secondary malignant glaucoma).The relevant data of the two groups of patients were compared,and the factors that might lead to secondary malignant glaucoma were recorded and analyzed.Results There were significant differences in age,axial length,lens thickness,preoperative intraocular pressure,anterior chamber depth and angle structure between the two groups(P<0.05).There were no significant differences in gender,education level,family income per capita,hypertension,diabetes mellitus and coronary heart disease between the two groups(P>0.05).Logistic regression analysis showed that age≤60 years,high preoperative intraocular pressure,angle closed completely,axial length<22 mm,lens thickness<4.5 mm,and anterior chamber depth<2 mm were all risk factors for secondary malignant glaucoma after PACG trabeculectomy(OR>1,P<0.05).Conclusion Age,preoperative intraocular pressure,anterior chamber angle structure,axial length,lens thickness and anterior chamber depth all increase the risk of malignant glaucoma in patients with PACG.For patients with such risk factors,preoperative symptomatic treatment should be actively taken to reduce the risk of malignant glaucoma in patients after surgery and improve the prognosis of patients.
作者
王雪林
常嘉泰
苏文华
何良飞
WANG Xue-lin;CHANG Jia-tai;SU Wen-hua;HE Liang-fei(Department of Ophthalmology,the First Affiliated Hospital of Jiangxi Medical College,Shangrao 334000,China)
出处
《中国当代医药》
2020年第2期145-148,共4页
China Modern Medicine
基金
江西省卫生计生委科技计划项目(20185548)
