CAJ | 학술논문

目的探讨早期玻璃体切除术治疗眼前节开放性损伤的疗效.方法回顾性分析2006年1月至2009年2月间住院的72例(72只眼)眼前节开放性损伤患者的病例资料,均先后行以玻璃体切除为主要方式的手术治疗.其中早期手术组32例(一期缝合术后1～3周行二期手术),晚期手术组40例(一期缝合术后1～4月行二期手术).观察比较其疗效.随访3～18个月,平均6.8个月.用SPSS13.0统计软件包分析,采用X2检验,以a=0.05为检验水准.结果 (1)损伤Ⅱ区中巩膜伤道内口玻璃体嵌顿情况(分级参照刘文等的巩膜穿刺内口玻璃体嵌顿的分级方法):Ⅱ级以上早期手术组73.7%(14/19),晚期手术组81.0%(17/21);Ⅲ级以上早期手术组10.5%(2/19),晚期手术组57.1%(12/21),Ⅲ级以上差异有统计学意义(X 2=9.53P=0.002).(2)玻璃体手术复杂程度及硅油填充情况:早期手术组行复杂的玻璃体视网膜手术2例(6.3%),晚期手术组13例(32.5%),差异有统计学意义(X2=7.427P=0.006);早期手术组硅油填充4例(12.5%),晚期手术组14例(35.0%,),差异有统计学意义(X2=4.80 P=0.028).(3)术后(3月)最佳矫正视力:两组术后视力明显提高,脱盲率(视力≥0.05)早期手术组87.5%(28/32),晚期手术组67.5%(27/40),差异有统计学意义(X2=3.943 P=0.047).(4)术后并发症:早期手术组视网膜脱离1例,硅油填充未取出1例,无眼球萎缩病例.晚期手术组视网膜脱离8例,硅油填充未取出4例,眼球趋于萎缩2例.结论玻璃体手术是治疗眼前节开放性损伤的有效方法,早期手术能更好地改善伤眼的结局及视力预后.
목적 탐토조기파리체절제술치료안전절개방성손상적료효.방법 회고성분석2006년1월지2009년2월간주원적72례(72지안)안전절개방성손상환자적병례자료,균선후행이파리체절제위주요방식적수술치료.기중조기수술조32례(일기봉합술후1～3주행이기수술),만기수술조40례(일기봉합술후1～4월행이기수술).관찰비교기료효.수방3～18개월,평균6.8개월.용SPSS13.0통계연건포분석,채용X2검험,이a=0.05위검험수준.결과 (1)손상Ⅱ구중공막상도내구파리체감돈정황(분급삼조류문등적공막천자내구파리체감돈적분급방법):Ⅱ급이상조기수술조73.7%(14/19),만기수술조81.0%(17/21);Ⅲ급이상조기수술조10.5%(2/19),만기수술조57.1%(12/21),Ⅲ급이상차이유통계학의의(X 2=9.53P=0.002).(2)파리체수술복잡정도급규유전충정황:조기수술조행복잡적파리체시망막수술2례(6.3%),만기수술조13례(32.5%),차이유통계학의의(X2=7.427P=0.006);조기수술조규유전충4례(12.5%),만기수술조14례(35.0%,),차이유통계학의의(X2=4.80 P=0.028).(3)술후(3월)최가교정시력:량조술후시력명현제고,탈맹솔(시력≥0.05)조기수술조87.5%(28/32),만기수술조67.5%(27/40),차이유통계학의의(X2=3.943 P=0.047).(4)술후병발증:조기수술조시망막탈리1례,규유전충미취출1례,무안구위축병례.만기수술조시망막탈리8례,규유전충미취출4례,안구추우위축2례.결론 파리체수술시치료안전절개방성손상적유효방법,조기수술능경호지개선상안적결국급시력예후.
Objective To investigate the effect of the early vitrectomy on open anterior segment injury.Methods Analyzed 72 cases (72 eyes) with open anterior segment injury who underwent vitreous surgery as the primary method in our hospital from Jan.2006 to Feb.2009 retrospectively.The early-operation group enrolled 32 cases (1-3 weeks later who undergone bi-operation after the primary suture),the advanced stage group enrolled 40 cases (1-4 months later who undergone bi-operation after the primary suture).All cases were followed up 3-18 months,averaged 6.8 months to observe and compare the effect.All the factors were analyzed with SPSS13.0 statistical package,using X2 analysis,a=0.05 was used as the test standard.The classification of the sclera wound tract endostoma was in accordance with the method of the vitreous incarceration of sclerotic puncture endostoma of Liu-wen,etc.Results 1.The vitreous incarceration of the sclera wound tract endostoma (the grade Ⅱ border damage):Above the grade Ⅱ of the early-operation group was 73.7%(14/19),the advanced stage group 81.0%(17/21);Above grade Ⅲ of the early-operation group 10.5% (2/19),the advanced stage group 57.1%(12/21),the incidence rate distinction above grade Ⅲ had statistical significance (X2=9.53,P=0.002).2.The complexity of the vitreous surgery and the padding of silicone oil:There were 2 cases (6.3%) who undergone complex vitreo-retinal surgery in the early-operation group,13 cases(32.50%)in the advanced stage group,the incidence rate distinction had statistical significance(X2=7.427,P=0.006);4 cases (12.5%) who undergone the padding off silicone oil in the early-operation group and 14cases (35.0%) in the advanced stage group,the incidence rate distinction had statistical significance (x2=4.80,P=0.028).3.The best corrected vision after the surgery (3months):The vision of the two groups improved obviously, de-blind rate (the vision≥ 0.05 ): the early-operation group was 87.5% (28/32), the advanced stage group 67.5% (27/40), the incidence rate distinction had statistical significance (X2=3.943, P=0.047). 4. Postoperative complications: 1 case had retinal detachment in the early-operation group, 1 did not take out the filled silicone oil, and there were no cases of atrophia bulbi. The advanced stage group had 8 cases of retinal detachment, 4 cases who filled with silicone oil did not take out, and there were 2 cases of atrophia bulbi. Conclusions The vitreous operation is the effective treatment method in the open anterior segment injury. Early operation can improve the outcome and vision of the injury eye better.