睫状体冷冻联合球后注射氯丙嗪治疗绝对期青光眼的疗效

Cyclocryotherapy combined with retrobulbar injection chlorpromazine in the treatment of glaucoma consummatum

目的观察和评价临床采用睫状体冷冻联合球后注射氯丙嗪治疗方案治疗绝对期青光眼患者的疗效。方法选择本院2010年2月～2012年4月收治的38例绝对期青光眼患者为研究对象,采用1.5mL2%利多卡因和1.0mL氯丙嗪按照临床常规的方法进行球后注射,在患者角膜边缘3mm处经过球结膜将睫状体直接冷冻,温度设定为-70℃,每点的冷冻时间为1min,共冷冻6～7个点,疗程为3个月,观察患者治疗前后眼压以及临床症状。结果患者在疗程结束后,眼压为9.8～28.7mmHg,平均眼压为(22.3±4.2)mmHg,较治疗前患者平均眼压有明显下降(P<0.05);患者眼痛、眼胀、头痛等临床症状明显减少(P<0.05),患者未出现严重的并发症。结论临床上对绝对期青光眼患者采用睫状体冷冻联合球后注射氯丙嗪是一种安全有效且经济的治疗方法,值得在临床上广泛推广和应用。

Objective To observe and analyze the efficacy of cyclocryotherapy combined with retrobulbar injection chlorpromazine in the treatment of glaucoma consummatum. Methods Thirty-eight patients with glaucoma consummatum treated in our hospital from February 2010 to April 2012 were chosen and given conventional retrobulbar injection with 1.5 mL 2% Lidocaine and 1.0 mL Chlorpromazine. Ciliary bodies of the patients were directly frozen from 3 mm beside corneal edge through bulbar conjunctiva with temperature set at -70 ℃ and the freezing time of 1 minute per point for 6 to 7 points. The course of treatment was three months and intraocular pressure as well as the clinical symptoms of the patients were observed before and after treatment. Results Statistically significant differences （P 0.05） existed in intraocular pressure and mean intraocular pressure before and after treatment with the intraocular pressure of 9.8-28.7mm Hg and mean intraocular pressure of （22.3 ±4.2）mm Hg after treatment. Statistically significant differences （P 0.05） also existed in symptoms s as ophthalmalgia, eye swelling and headache before and after treatment. The patients didn＇t show severe complications. Conclusion Cyclocryotherapy combined with retrobulbar injection chlorpromazine is an safe, effective and economic way to treat glaucoma consummatum and is worthy of clinical application.