超声乳化术前因素与术后早期角膜内皮细胞丢失的关系-眼科学专业论文.docxVIP

万方数据 万方数据 汕头大学医学院硕士学位论文 汕头大学医学院硕士学位论文 摘要 目的：探究多种术前可观测因素与白内障超声乳化吸除术后早期角膜内皮细胞丢失量之间 的关系。 方法：选择自 2013 年 7 月至 2014 年 2 月期间在汕头大学医学院第一附属医院眼科行白内 障手术的患者 79 人(103 眼)。术前记录患者的年龄、性别、诊断、晶体核硬度，并用非接 触式角膜内皮计 SP3000P 测量患者的中央角膜内皮，测得中央角膜内皮的最小面积、最大 面积、平均面积、面积标准差、面积变异系数、细胞密度、六角形细胞百分率。术后 1 周 内再次测量中央角膜内皮，得到术后中央角膜内皮细胞密度。计算角膜内皮细胞丢失量， 通过逐步回归分析探究术前因素与术后早期角膜内皮细胞丢失的关系，对引起显著差异的 术前因素做方差分析。 结果：核硬度与年龄进入回归方程并且被保留，回归系数分别为 189.325 和 6.22，其余因 素被移除。核硬度与年龄的交互效应显著性无统计学意义（P＞0.05）。把年龄作为协变量 控制后，II 级核与 III、IV、V 级核比较均有显著差异（P＜0.01），III 级核与 IV、V 级核 比较有显著差异（P＜0.05），IV 级核与 V 级核比较无显著差异（P＞0.05）。 结论：晶体核硬度、年龄都与超声乳化术后早期角膜内皮细胞的丢失量呈正相关，且两者 之间未见明显交互效应。核硬度与年龄在术前应同时被考虑。年龄一定时，晶体核硬度越 大，术后早期角膜内皮细胞丢失量越大。晶体核硬度一定时，年龄越大，术后早期角膜内 皮细胞丢失量越大。基础疾病在控制良好的情况下，超声乳化术后早期的角膜内皮细胞丢 失量未见明显差异。术前角膜内皮的分析数据与术后早期角膜内皮细胞的丢失量之间未见 明显相关性。 关键词：白内障，超声乳化吸除术，术前因素，角膜内皮细胞丢失量 I Abstract Objective：To investigate the correlation between observable preoperative factors and corneal endothelial cell loss（ECL）at the early stage after phacoemulsification and aspiration. Methods ： 79 patients (103 eyes) were studied at the ophthalmology department of the first Affiliated Hospital of Shantou University Medical College from July 2013 to February 2014. Age, sex, diagnosis and nuclear hardness of lens were recorded, minimum size, maximum size, average size, standard deviation of size, coefficient variance of size, cell density and hexagonality of central corneal endothelium were measured by noncontact specular microscope (NCSM) SP3000P preoperatively. The cell density of central cornel endothelium was measured postoperatively within 1 week. After the calculation of corneal endothelial cell loss (ECL), stepwise regression was introduced to analyse the correlation between the preoperative factors observed and ECL. The correlated preoperative factors were further analysed by variance analysis. Results：Only nuclear hardness and age were reserved in regression equation, with regression coefficient of 189.325 and 6.22 respectively. The interaction between nuclear hardness and age h