曲安奈德干预治疗葡萄膜炎并发白内障的临床研究

Clinical study of Triamcinolone acetonide to treat patients with uveitis complicated by cataract

目的:探讨葡萄膜炎并发白内障患者术后应用曲安奈德的治疗效果。方法:收集48例葡萄膜炎并发白内障术后患者,按入组编号随机分为观察组与对照组,每组各24例,观察组应用曲安奈德联合泼尼松龙干预治疗,对照组单用泼尼松龙,对比观察两组患者术后视力恢复情况、眼压变化情况、前房炎症反应情况、并发症发生情况,并随访3个月观察复发情况。结果:观察组术后视力恢复情况优于对照组,术后1 d虽无统计学意义(P>0.05),但术后一周及一个月,观察组分别为15例、18例,而对照组为11例、12例,两组比较差异均有统计学意义(P<0.05);两组患者术后眼压较术前均降低,但术后1 d及1周相比差异均无统计学意义(P>0.05);观察组前房炎症反应程度低于对照组,术后1 d及1周两组相比差异均有统计学意义(P<0.05);观察组并发症发生率及复发率分别为20.83%、12.50%,低于对照组的37.50%、25.00%,两组比较差异均有统计学意义(P<0.05)。结论:曲安奈德干预治疗葡萄膜炎并发白内障术后患者效果肯定,患者不仅视力恢复快、前房炎症反应轻,且并发症少、复发率低,临床值得推广应用。

Objective： To study the effect of Triamcinolone acetonide to treat patients with uveitis and cataract after surgery.Methods： 48 cases with uveitis and cataract after surgery were collected and divided into control group and observation group according to numbers,each group had 24 cases.The observation group was given Triamcinolone acetonide combined with Prednisolone,while the control group was given Prednisolone only.The recovery of visual acuity,intraocular pressure changes,anterior chamber inflammation,complications occurrence were compared and the recurrence was observed at the follow-up visit after 3 months.Results： The recovery of visual acuity after surgery in the observation group was better than the control group,the result of the first postoperative day was no significant（P0.05）,but the results after a week and a month in the observation group were respectively 15 cases and 18 cases,while the control group were 11 cases and 12 cases,the differences were significant（P0.05）;the preoperative intraocular pressure between the two groups were all lower than postoperation,but there were no significant differences compared with the results of one day and one week after surgery（P0.05）;the level of anterior chamber inflammation of the observation group was lower than the control group,the level of 1 day and 1 week after surgery compared between the two groups were significantly different（P0.05）;the rate of complications and recurrence in the observation group was respectively 20.83%,12.50%,lower than the control group（37.50%,25.00%）.The difference was statistically significant（P0.05）.Conclusion： The effect of Triamcinolone acetonide to treat patients with uveitis and cataract after surgery is conformed.Not only the visual recovery is faster,the anterior chamber inflammation is mild,but also the rate of complications and recurrence is lower.It is worthy to be widely used in the clinical.