CAJ | 학술논문

目的探讨儿童眼内炎玻璃体切割(玻切)术后视网膜脱离的临床特点,并分析其影响因素和预后,为临床防治提供指导.方法回顾分析2002年1月至2007年12月我院114例儿童眼内炎患者行玻切术后视网膜脱离33例33只眼的的临床资料.并根据眼内炎玻切术式不同分为4组,Ⅰ组(巩膜外环扎+玻切+曲安奈德注射+眼内光凝+硅油填充)19只眼,Ⅱ组(巩膜外环扎+玻切+眼内光凝+硅油填充)23只眼,Ⅲ组(巩膜外环扎+玻切+硅油填充)37只眼,Ⅳ组(玻切+巩膜外环扎)35只眼.视网膜脱离复位术后随访≥16月.结果儿童眼内炎玻切术后视网膜脱离的总发生率为28.95%.各组发生率依次为:10.53%,26.09%,29.73%,40.00%.经χ2分割法检验,Ⅰ组与Ⅳ组,Ⅱ组与Ⅳ组,Ⅲ组与Ⅳ组,Ⅰ组与Ⅱ组,Ⅰ组与Ⅲ组术后视网膜脱离发生率均有统计学意义(P<0.05),Ⅱ组与Ⅲ组术后视网膜脱离发生率无统计学意义(P>0.05).除4只眼放弃治疗外,所有病例炎症得到控制、视网膜复位.结论儿童眼内炎因其自身特点,玻璃体切割联合巩膜外环扎、曲安奈德注射、眼内光凝、硅油填充术可有效预防眼内炎术后视网膜脱离的发生.
목적 탐토인동안내염파리체절할(파절)술후시망막탈리적림상특점,병분석기영향인소화예후,위림상방치제공지도.방법 회고분석2002년1월지2007년12월아원114례인동안내염환자행파절술후시망막탈리33례33지안적적림상자료.병근거안내염파절술식불동분위4조,Ⅰ조(공막외배찰+파절+곡안내덕주사+안내광응+규유전충)19지안,Ⅱ조(공막외배찰+파절+안내광응+규유전충)23지안,Ⅲ조(공막외배찰+파절+규유전충)37지안,Ⅳ조(파절+공막외배찰)35지안.시망막탈리복위술후수방≥16월.결과 인동안내염파절술후시망막탈리적총발생솔위28.95%.각조발생솔의차위:10.53%,26.09%,29.73%,40.00%.경χ2분할법검험,Ⅰ조여Ⅳ조,Ⅱ조여Ⅳ조,Ⅲ조여Ⅳ조,Ⅰ조여Ⅱ조,Ⅰ조여Ⅲ조술후시망막탈리발생솔균유통계학의의(P<0.05),Ⅱ조여Ⅲ조술후시망막탈리발생솔무통계학의의(P>0.05).제4지안방기치료외,소유병례염증득도공제、시망막복위.결론 인동안내염인기자신특점,파리체절할연합공막외배찰、곡안내덕주사、안내광응、규유전충술가유효예방안내염술후시망막탈리적발생.
Objective To investigate the clinical features and characteristics of the retinal detachment after vitrectomy of endophthalmitis in children, and also investigated its relative influential factors and prognosis.In order to guide clinical prevention and treatment.Methods We studied the related clinical data of 33 cases (33 eyes)with a clinical diagnosis of the retinal detachment after vitrectomy among 114 cases (114 eyes)endophthaimitis in child in our hospital from Jan, 2002 to Dec, 2007, and divided them into four different groups according to the styles of vitrectomy.All the patients were followed - up longer than 6 months after the reduction of retinal detachment.Results The general rate of retinal detachment after vitrectomy of endophthalmitis in children was 28.95%.In the four different styles of vitrectomy, 19 eyes in group Ⅰ were treated by ringing out of sclera, vitrectomy, injecting TA into the vitreous cavity, inwaocular photocoagnlation and silicone oil filled. 23 eyes in group Ⅱ were treated by ringing out of sclera,vitrectomy,intraocular photocoagulation and silicone oil filled.37 eyes in group Ⅲ were treated by ringing out of sclera, vitrectomy and silicone oil filled.35 eyes in group IV were treated by ringing out of sclera and vitrectomy.The rates of retinal detachment after vitrectomy were 10.53% ,26.09%,29.73% and 40.00% by aLms.The data were processed with partitions of x2 method.The differences were statistically significant (P <0.05)between Ⅰ and Ⅳ group,Ⅱ and Ⅳ group,Ⅲ and Ⅳ group,Ⅰ and Ⅱ group, Ⅰ and Ⅲ group, hut there was no differences betwee Ⅱ and Ⅲ group (P >0.05).The infection were controlled and retina were reset of all cases except 4 cases who gave up treatment.Conclnsions As for the clinical features of endophthalmitis in children, The style of vitrectomy combining with ringing out of sclera, injecting triamcinoione into the vitreous cavity, intraocular photocoagulation and silicone oil filled was effective in prevention of the retinal detachment after vitrectomy of endophthalmitis in children.