| Speciality:Cinical ophthalmology of TCMAuthor:Ma wei qiTutou:Prof.QiuboResearch purposes①A retrospective study Phaco + Iol surgery(phacoemulsification combined with intraocular lens implantation),Trab surgery(trabeculectomy), Phaco + Iol + Trab(phacoemulsification combined with intraocular lens implantation combined with trabeculectomy) three different surgical treatment of primary angle-closure glaucoma in the short-term clinical efficacy.②Research Phaco + Iol surgery,Trab surgery,Phaco + Iol + Trab three different surgical treatment of primary angle-closure glaucoma in the long-term clinical efficacy.③Study of primary angle-closure glaucoma in patients with syndrome of traditional Chinese medicine.Research Methods①statistics collected and early September 2002-2008 in March because of primary angle-closure glaucoma patient in our hospital to exclude non-line mode of operation of the three patients,has ruled out surgery eye surgery twice,ruled out major surgery eye troubles eye diseases(uveitis,ocular trauma,vitreous hemorrhage,vitreoretinal disease,etc.),the results of the analysis of patients affected.Clinical studies with the inclusion criteria of a total of 266 eyes,in which ultra-pure milk 139 eyes,84 eyes trabecular simple,simple triple 43 eyes,the average age of 65.71±10.86 years old age.②collection meet the above criteria of patients into the patient's age, preoperative visual acuity,intraocular pressure on admission,the day before surgery intraocular pressure,preoperative vision,preoperative central anterior chamber depth,visual acuity after 1 week,1 week after eye pressure and other clinical indicators.The use of statistical software to establish a database SPSS13.0.The use of exploratory analysis,normality test to analyze the operation of the clinical data,using rank sum test in each group to study the clinical indicators of pre-operative differences in study group after the short-term clinical efficacy.③meet the inclusion criteria of patients,after an average follow-up of 24.91±18.15 months,a total of 91 follow-up,in which 47 people Phacao surgery,Trab group of 29 patients,Phaco + Iol group of 15 patients.Referral of patients to collect when the clinical indicators(referral when vision, when the intraocular pressure referral,referral when vision and follow-up visits when the central anterior chamber depth).The use of statistical software to establish a database SPSS13.0.The use of exploratory analysis, normality test to analyze the operation of the clinical data,using rank sum test after each group to study the long-term clinical efficacy.④collection in line with the standards of clinical studies in patients with TCM syndrome(stagnation of liver qi stagnation,liver and gall-bladder-type pressure fire type,intrinsic type heat,yin deficiency type Huowang,spleen wet storm type,liver by wind-heat type) and patients before and after the clinical indicators,a total of 189 people,266 eyes,in which ultra-pure milk 139 eyes,84 eyes trabecular simple,simple triple 43 eyes, the average age of 65.71±10.86 years old age.SPSS13.0 use statistical software to establish a database,the use of frequency distribution analysis to the TCM Syndrome statistical distribution;using chi-square test to analyze their respective AACG and CACG TCM Syndrome distribution;rank sum test used to analyze the TCM Designate of the clinical indicators;the use of multi-factor analysis of variance to analyze the TCM Syndrome and various clinical indicators.The results①Preoperative:Phaco + Iol surgery group,Phaco + Iol + Trab surgery preoperative vision,vision of MS patients was lower Trab group;the central anterior chamber depth preoperatively Phaco + Iol surgery group in shallow Trab surgery group,with statistical difference significance.②Short-term clinical efficacy:Admission IOP - intraocular pressure after 1 week worse Phaco + Iol surgery group patients is less than Trab group; 1 days preoperative IOP - intraocular pressure after 1 week worse Phaco + Iol surgery group than Phaco + Iol + Trab surgery group;after 1 week of preoperative visual acuity and poor visual acuity,Phacao + Iol Operation Group＞Phaco + Iol + Trab surgery group＞Trab surgery group,the differences are statistically significant.③Long-term clinical efficacy:referral vision - poor preoperative visual acuity,central anterior chamber depth before and after surgery group than in Trab poor Phacao + Iol surgery and Phaco + Iol + Trab surgery group; Trab surgery group at follow-up visits shallow central anterior chamber depth Phaco + Iol patients in group and Phaco + Iol + Trab surgery group,with statistically significant differences;three groups when the intraocular pressure referral,admission IOP - intraocular pressure follow-up visits when the poor,1 day preoperative IOP - intraocular pressure follow-up visits when the difference There was no statistical difference.Trab but 27 cases of postoperative follow-up visits,of which 3 cases required two kinds of drugs to lower intraocular pressure control of intraocular pressure to the normal range,four cases required one kinds of lowering intraocular pressure intraocular pressure control of drug to the normal range;Phaco + Iol + Trab 14 cases of postoperative follow-up visits,of which one cases of intraocular pressure lowering drugs will be needed to control intraocular pressure to normal range.Due to fewer cases,no statistically significant only for descriptive statistics.④TCM Syndrome Study:primary angle-closure glaucoma in Chinese medicine syndromes of stagnation of liver Qi stagnation in the distribution of type, followed by type Huowang deficiency.Primary acute angle-closure glaucoma (AACG) Liver depression and Qi stagnation is the largest type,and primary chronic angle-closure glaucoma(CACG) deficiency is the most Huowang type. liver and gall-bladder-type pressure fire type of admission the highest intraocular pressure,liver and gall-bladder-type pressure fire type -based preoperative IOP 1 day,1 week after IOP,intraocular pressure follow-up visits were at the lowest intrinsic heat-type 1 day preoperative and postoperative intraocular pressure when the eyes referral pressure are the highest,followed by stagnation of liver qi stagnation.Spleen wet storm-based preoperative central anterior chamber depth the deepest,stagnation of liver Qi stagnation type preoperative most shallow central anterior chamber depth. Conclusion of the studyPhaco + Iol surgery group and surgery Trab group differences in preoperative clinical indicators of the main lens opacity is the degree of impact on visual function,preoperative central anterior chamber depth;Phaco + Iol surgery group and Phaco + Iol + Trab surgery preoperative clinical data of group no significant difference.②surgery in three groups of intraocular pressure lowering effect of the near future,Phaco + Iol surgery group difference in patients Trab and Phaco + Iol + Trab surgery group;three groups of surgical method to improve the visual aspect in the near future,Phaco + Iol surgery was superior to Phaco + Iol + Trab surgery group(considering the possibility and degree of optic nerve damage) and the surgery group Trab.③The mean follow-up 24.91±18.152 months,Trab surgery group in the long-term improvement in visual function,anterior chamber depth deepened worse than Phaco + Iol surgery and Phaco + Iol + Trab.Three groups in the long-term effect of lowering intraocular pressure was no significant difference.Three groups of patients need follow-up visits when the frequency of drug reduced intraocular pressure were:Phaco + Iol(4.7%)＜Phaco + Iol + Trab(7.1%)＜Trab(25.9%).(4) primary angle-closure glaucoma(AACG and CACG) TCM syndrome of stagnation of liver Qi stagnation in the number of type cases,primary angle-closure glaucoma in the liver and gall-bladder-type pressure fire type of intervention,the larger pressure drop,better control of intraocular pressure,and inner heat and stagnation of liver Qi stagnation type of intervention in the operation to reduce the intraocular pressure less than the rate in liver and gall-bladder-type pressure fire type,the difference has statistical significance.
|
PDF Full Text Request