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葡萄膜炎的诊断性前房穿刺术:一种安全的操作?

Diagnostic anterior chamber paracentesis in uveitis: a safe procedure?

作者信息

Van der Lelij A, Rothova A

机构信息

Department of Ophthalmology, F C Donders Institute, University Hospital Utrecht, Netherlands.

出版信息

Br J Ophthalmol. 1997 Nov;81(11):976-9. doi: 10.1136/bjo.81.11.976.

Abstract

BACKGROUND

Differentiation between infectious and non-infectious uveitis is of crucial value for accurate management of patients with uveitis. Tests performed on aqueous humour yield more relevant information than those done in serum. The objective of this study was to evaluate whether the aqueous humour tap for diagnostic purposes is a safe procedure to perform in uveitis patients.

METHODS

In this retrospective study 361 patients with uveitis, who underwent a diagnostic anterior chamber paracentesis in an outpatient clinic, were investigated. 72 of the 361 patients were examined 30 minutes after the puncture. The site of the paracentesis, the depth of the anterior chamber, and cells in the anterior chamber were examined. All 361 patients were evaluated within 2 weeks after the paracentesis was performed. The final follow up period varied from 6 months to more than 3 years. The clinical data were analysed with the emphasis on the occurrence of cataract and a history of corneal infections or endophthalmitis.

RESULTS

In this series no serious side effects such as cataract, keratitis, or endophthalmitis were observed. The depth of the anterior chamber of all evaluated patients was restored after 30 minutes. In five out of 72 cases (three AIDS patients with cytomegalovirus retinitis and two patients with anterior uveitis due to herpes simplex virus) a small hyphaema was observed 30 minutes after the paracentesis took place.

CONCLUSION

Anterior chamber paracentesis appears to be a safe procedure in the hands of an experienced ophthalmologist.

摘要

背景

区分感染性和非感染性葡萄膜炎对于准确治疗葡萄膜炎患者至关重要。对房水进行的检测比血清检测能提供更相关的信息。本研究的目的是评估为诊断目的进行房水穿刺在葡萄膜炎患者中是否是一种安全的操作。

方法

在这项回顾性研究中,调查了361例在门诊接受诊断性前房穿刺的葡萄膜炎患者。361例患者中有72例在穿刺后30分钟接受检查。检查穿刺部位、前房深度和前房内的细胞。所有361例患者在穿刺后2周内进行评估。最终随访期从6个月到3年以上不等。分析临床数据,重点关注白内障的发生情况以及角膜感染或眼内炎病史。

结果

在本系列研究中,未观察到白内障、角膜炎或眼内炎等严重副作用。所有评估患者的前房深度在30分钟后恢复。在72例病例中的5例(3例患有巨细胞病毒性视网膜炎的艾滋病患者和2例因单纯疱疹病毒导致前葡萄膜炎的患者),穿刺后30分钟观察到少量前房积血。

结论

在经验丰富的眼科医生操作下,前房穿刺似乎是一种安全的操作。

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