彩色多普勒超声检查在“复明工程”的应用分析

Application of Color Doppler Ultrasound on Preoperative Examination in Preventing Blinding Project

目的:探讨彩色多普勒超声在白内障复明工程中进行眼部术前检查的应用价值。方法:对本院确诊白内障并纳入"复明工程"的103例患者(103只眼)术前行患眼彩色多普勒超声和裂隙灯检查。观察晶状体前后囊及内部回声,并与裂隙灯下晶状体检查对比分析;测量晶状体厚度、后囊长度;观察玻璃体、视网膜及球后回声;观察患眼视网膜中央动脉的血流动力学并以对侧健眼作对比分析。结果:彩色多普勒超声下白内障声像图表现为晶状体增厚,后囊膜回声增强、增厚;晶状体混浊部位回声稍强,分皮质型46例、核型21例、后囊膜下型11例、全混型25例;晶状体超声检测分型与裂隙灯检测比较差异无统计学意义(χ2=1.253,P=0.74)。视网膜中央动脉的血流动力学检查与对侧健眼比较差异有统计学意义。103例白内障患者(103只眼)探查后有37眼玻璃体混浊,3眼晶状体半脱位或悬韧带异常,3眼视网膜脱离,17眼球后三角区后巩膜葡萄肿。结论:白内障术前彩色多普勒超声检测可弥补眼科裂隙灯检查的不足,快速了解眼球内及眼球后的情况;患眼的视网膜中央动脉的血流动力学与健眼比较有差异,且术后有改善;彩色多普勒超声检查可列为白内障复明工程筛查的常规检查。

Objective To investigate the clinical value of color Doppler ultrasound in diagnosis of patients with cataract in preventing blinding project before operation.Methods Total 103 eyes of 103 patients that confirmed cataract were enrolled in the preventing blinding project,and all recieved color Doppler ultrasound and slit lamp examination preoperation.The anterior and posterior capsule,internal echo of crystalline lens were observed and compared with the examination results of slit lamp,and then the thickness of crystalline lens,length of posterior capsule were determined.The states of vitreous body,retina and echo back eyeball were recorded. The hemodynamics of central retinal artery were compared between affected eyes and oppositeside normal eyes.Results The ultrasonogram of eyes with cataract showed that the thicknesses of lens and posterior capsule were increased,echo of posterior capsule was strengthened.The echo of lens in opacification region was slightly strengthened,the typing of lens determined with color Doppler ultrasound showed that 46 cases were cortical type,21 cases were caryotype,11 cases were below posterior capsule type,25 cases were complete opacification type. The results of lens typing that determined by color Doppler ultrasound and slit lamp had no significant difference（ χ^2= 1.253,P = 0.74）.The hemodynamics of central retinal artery had significant differences between affected eyes and oppositeside normal eyes.Finally,37 eyes with vitreous opacification,3 eyes with subluxation of lens or suspensory ligament abnormal,17 eyes with posterior scleral staphyloma in triangular area back eyeballs were confirmed from 103 eyes of 103 patients with cataract.Conclusion Preoperative color Doppler ultrasound examination could retrieve the shortage of slit lamp in confirming cataract,and quickly understand the states interior and posterior eyeball.The hemodynamics of central retinal artery had significant differences between affected eyes and oppositeside normal eyes,and which was improved postoperation.Color Doppler ultrasound could be listed as a routine examination for patients with cataract in preventing blinding project.