三种娩核方式在小切口非超声乳化白内障手术中临床观察.doc

三种娩核方式在小切口非超声乳化白内障手术中临床观察 廖文江 闫亚红 刘贤升 柯美魁 （九江市第一人民医院眼科 九江 332000） 〔摘要〕目的：探讨应用注水圈套器娩核法、水压娩核法和前房内劈核法三种不同娩核方式在小切口非超乳白内障手术应用的特点和疗效。 方法：对324例（324眼）老年性白内障患者，随机分成三组，分别通过注水圈套器娩核法、水压娩核法和前房内劈核法完成娩核过程，观察记录娩核时间、术中并发症、术后第一天角膜内皮水肿程度，统计学处理差异。 结果：娩核时间：注水圈套器娩核法平均时间45s、水压娩核法平均时间34s和前房内劈核法平均时间65s, 三组的平均娩核时间均存在统计学差异（P﹤0.05）。注水圈套器娩核法和前房内劈核法的并发症主要表现为虹膜损伤和后囊膜破裂；水压娩核法则主要表现为前房出血。角膜水肿：A组（注水圈套器娩核法）：0-1级：81眼；2-3级：27眼；B组（水压娩核法）：0-1级：101眼；2-3级：7眼；C组（前房内劈核法）：0-1级：73；2-3级：35眼。三组均未出现4级角膜水肿，统计学分析，A组与B组、B与C组均有显著性差异（P﹤0.05），A与C组统计学处理无显著性差异（P﹥0.05）。 结论：前房内劈核法对Ⅳ级以上核的处理优势是明显的；水压娩核法术中并发症少，术后第一天角膜内皮水肿发生率低，更适用于Ⅳ级以下的核娩出。 关键词：注水圈套器娩核法、前房内劈核法、水压娩核法、小切口非超乳白内障手术 Clinical observation of extracting nucleus using lens loop ；water irrigation and manual fragmentation during on-phacoemulsification with small incision。 LIAO Wen-jiang*YAN Ya-hong;LIU Xian-sheng;KE Mei-kui *The First People’s Hospital Of Jiujiang，Jiujiang,jiangxi ，332000，China 〔Abstact〕Objective：To compare the clinical effect and advantage of extracting nucleus using lens loop ;water irrigation and manual fragmentation during non-phacoemulsification with small incision.Methods：324 cases (324) in patients with age-related cataract were randomly divided into three groups, by the lens loop; water irrigation and manual fragmentation method to complete the process of lens nucleus, observed and recorded delivery nucleation time, complication during operation, postoperative day corner edema.Results：The average extracting nucleus times were 45″in lens loop group; 34″in water irrigation group and 65″in manual fragmentation group, The statistical analysis of three groups were significant differences (P 0.05), and the complications in lens loop and manual fragmentation are iris trauma and posterior capsular rupture; the complication in the water irrigation is hyphema. Corneal edema: group A (lens loop ): 0 to 1: 81; 2 to 3: 27. B group (water irrigation): 0 to 1: 101; 2 ~ 3: 7. C group (manual fragmentation ): 0 to 1: 73; 2 to