老年性白内障合并血液疾病患者手术治疗的临床疗效分析

摘要

AIM: To evaluate the clinical efficacy of cataract extraction and intraocular lens implantation in patients with senile cataract and hematologic disease. METHODS:Forty patients (58 eyes) with senile cataract and hematologic disease underwent cataract extraction and intraocular lens implantation. Preoperative assessment included blood coagulation testing, leukocyte classification, and bone marrow examination. Appropriate preoperative treatments were administered to patients with senile cataract and thrombocytopenia, leukopenia, anemia, and/or pancytopenia ( identified through blood testing ) . Thirty patients with senile cataract and normal routine bloodwork findings, with ages similar to those of patients in the study group, were randomly recruited as a control group. Postoperative corrected visual acuity and intraoperative and postoperative complications were recorded.The causes of hematologic disease in patients in the study group were recorded.Blood clotting data were c ompared between groups using t-tests. RESULTS: Plasma prothrombin time and activated partial thromboplastin time di d not differ significantly between the study and control groups ( P=0.379 and P=0.945, respectively).Surgery improved co rrected visual acuity in all patients (>0.4 in 56 [96.55%] eyes).No postoperative infection, bleeding or fever occurred.T he etiology of hematological disease was unknown in some paitents; most patients had diabetes mellitus, hypertension, cirrhosis, and/or kidney disease. CONCLUSION: With adequate perioperative treatment, patients with senile cataract and hematological disease can safely undergo cataract operation and intraocular lens implantation, with good outcome s.%目的：评估白内障摘除联合人工晶体植入术对老年性白内障合并血液疾病患者的临床疗效。方法：40例（58眼）老年性白内障合并血液疾病患者接受了白内障摘除联合人工晶体植入术。术前评估，包括凝血试验，白细胞分类和骨髓检查。对老年性白内障患者合并血小板减少，白细胞减少，贫血，全血细胞减少（通过血液检测确定）的患者给予适当的术前治疗。随机选择血液检查结果相似，年龄相仿的30例老年性白内障研究组患者的作为对照组。记录术后矫正视力，术中及术后并发症。记录研究组患者血液病的原因。采用t检验，对比两组的血液凝固数据。结果：研究组和对照组的血浆凝血酶原时间和活化部分凝血活酶时间没有显著差异（P＝0．379和P＝0．945）。所有患者手术矫正视力均有一定程度的改善（＞0．4，96.55％）。术后未发生感染，出血或发烧。部分患者血液病的病因不明；大多数患者有糖尿病，高血压，肝硬化或肾脏疾病。结论：有效的围手术期治疗，使老年性白内障合并血液疾病患者可以安全地进行白内障摘除联合人工晶体植入术，并且术后效果良好。