一例初诊开角型青光眼患者的循证治疗

Evidence-Based Treatment for a Newly Diagnosed Open-Angle Glaucoma Patient

目的借助循证医学的方法为1例双眼开角型青光眼(POAG)患者确定治疗目标及治疗方案,同时对诸多文献报道的POAG治疗进行回顾性总结。方法在充分评估患者情况后,提出临床问题,在Cochrane Library(2009年第4期)、PubMed数据库(1990～2009),MEDLINE(1990～2009)、EMbase(1990～2009)、CBM(1990～2009)、CNKI(1990～2009)中收集证据并评价其实用性。检索主题词包括open-angleglaucoma、timolol、latanoprost、trabeculectomy、intraocular pressure、RCT、human、meta-analysis、systematic review。中文检索词包括:开角型青光眼、噻吗洛尔、拉坦前列腺、小梁切除术、系统评价、Meta分析、随机对照试验。结果共检索出开角型青光眼治疗的临床指南3篇,不同问题相关的随机对照试验221篇,系统评价/Meta分析19篇。通过分析检索结果并结合患者意愿,为患者制定出合理的治疗方案。结论采用循证医学的方法,为初诊开角型青光眼患者确定合理的治疗方案,可有效提高患者治疗效果。

Objective Methods of evidence-based medicine were used to make an individualized treatment plan concerning newly diagnosed open-angle glaucoma patient.Methods After clinical problems were put forward,evidence was collected from Cochrane Library （Issue 4,2009）,PubMed （1990-2009）,MEDLINE （1990-2009）,EMbase （1990-2009）,CBM （1990-2009）,and CNKI （1990-2009） according to the search strategy.Subject words were open-angle glaucoma,timolol,latanoprost,trabeculectomy,intraocular pressure,randomized controlled trials,human,meta-analysis,systematic review.Results A total of 221 randomized controlled trials,and 19 systematic reviews were identified.A rational treatment plan was made upon a serious evaluation of the data.After one year follow-up,the plan was proved optimal.Conclusion The treatment efficacy in newly diagnosed open-angle glaucoma has been improved by determining an individualized treatment plan according to evidence-based methods.