糖尿病肾功能衰竭患者白内障手术的临床观察

Clinical observation on cataract surgery in patients with diabetic renal failure

目的观察经围手术期恰当处理及改进手术方法的糖尿病肾功能衰竭患者白内障手术的效果。方法回顾性临床研究。选取糖尿病肾功能衰竭的白内障行超声乳化手术43例（57眼），设为观察组，均经无肝素透析及控制血糖、血压等围手术期处理后进行超声乳化联合人工晶状体植入术，术中采用大吸力低能量及前后囊抛光等技术。选取一般条件相近但肾功能正常的糖尿病白内障45例（61眼）作为对照组。对术后并发症及术后3个月的视力进行两组间比较。结果并发症及术后3个月的视力两组间差异无统计学意义（P〉0．05）。结论在围手术期各个环节都严格控制及采用改进手术方法的前提下，糖尿病肾功能衰竭者的白内障手术是安全有效的治疗方法。

Objective To observe the efficacy of cataract surgery of patients with diabetic renal failure after proper treatment during perioperative period and improved surgical method. Methods A retrospective clinical study. The data of 57 eyes of 43 patients with cataract and diabetic renal failure were selected as observation group and they received phacoemulsification. All cases of observation group received non-heparin dialysis, control of blood glucose and blood pressure in perioperative period. During the operation, strong suction and low energy were applied, and anterior and posterior capsule polishing were performed. The data of 61 eyes of 45 patients with similar general conditions with the normal renal function and diabetic cataract were selected as control group. The postoperative complications and the visual acuity of 3 months after operation were compared between the two groups. Results There was no significant difference between the two groups in complication and the visual acuity 3 months after operation （ P 〉 0.05 ）. Conclusion Under the premise that all aspects of the perioperative period can be controlled strictly and the surgical method be improved, cataract surgery is a safe and effective treatment for cataract patients with diabetic renal failure.