国际眼科杂志
國際眼科雜誌
국제안과잡지
INTERNATIONAL JOURNAL OF OPHTHALMOLOGY
2014年
1期
112-115
,共4页
王雨晴%宋晏平%张招德%林文雅%唐涵锋
王雨晴%宋晏平%張招德%林文雅%唐涵鋒
왕우청%송안평%장초덕%림문아%당함봉
玻璃体切除术%并发症%临床
玻璃體切除術%併髮癥%臨床
파리체절제술%병발증%림상
vitrectomy%complication%clinic
组和<50岁组。分别观察玻璃体切除术后各组并发症的发生率、危险因素和处理方法。<br> 结果:研究表明玻璃体切除术后的主要并发症包括眼压升高、继发性青光眼、角膜病变、并发性白内障、玻璃体出血、视网膜脱离、医源性视网膜裂孔、前房渗出膜、脉络膜和睫状体脱离等。根据本组数据统计分析,认为单纯玻璃体切除组、惰性气体填充组和硅油填充组发生各种术后并发症有明显差异。其中,惰性气体填充组和硅油填充组术后眼压升高和继发性青光眼的发生率明显高于单纯玻璃体切除组,尤其是惰性气体填充组术后高眼压的发生率更高。惰性气体填充组和硅油填充组术后并发角膜病变和并发性白内障的发生率明显高于单纯玻璃体切除组,而且与术后高眼压密切相关。玻璃体出血、医源性视网膜裂孔、视网膜脱离、前房渗出膜、脉络膜和睫状体脱离等并发症各分组之间无显著差异。<br> 结论:玻璃体切除术是治疗严重玻璃体视网膜疾病的有效方法,术后大部分患者视力都得到了不同程度的提高。但是术后并发症严重影响了术后效果,如何提高手术技巧,避免减少和及时正确的处理术后并发症是玻璃体视网膜手术成功的关键,也是今后玻璃体切割术研究的重点,需要我们继续探索和研究。
組和<50歲組。分彆觀察玻璃體切除術後各組併髮癥的髮生率、危險因素和處理方法。<br> 結果:研究錶明玻璃體切除術後的主要併髮癥包括眼壓升高、繼髮性青光眼、角膜病變、併髮性白內障、玻璃體齣血、視網膜脫離、醫源性視網膜裂孔、前房滲齣膜、脈絡膜和睫狀體脫離等。根據本組數據統計分析,認為單純玻璃體切除組、惰性氣體填充組和硅油填充組髮生各種術後併髮癥有明顯差異。其中,惰性氣體填充組和硅油填充組術後眼壓升高和繼髮性青光眼的髮生率明顯高于單純玻璃體切除組,尤其是惰性氣體填充組術後高眼壓的髮生率更高。惰性氣體填充組和硅油填充組術後併髮角膜病變和併髮性白內障的髮生率明顯高于單純玻璃體切除組,而且與術後高眼壓密切相關。玻璃體齣血、醫源性視網膜裂孔、視網膜脫離、前房滲齣膜、脈絡膜和睫狀體脫離等併髮癥各分組之間無顯著差異。<br> 結論:玻璃體切除術是治療嚴重玻璃體視網膜疾病的有效方法,術後大部分患者視力都得到瞭不同程度的提高。但是術後併髮癥嚴重影響瞭術後效果,如何提高手術技巧,避免減少和及時正確的處理術後併髮癥是玻璃體視網膜手術成功的關鍵,也是今後玻璃體切割術研究的重點,需要我們繼續探索和研究。
조화<50세조。분별관찰파리체절제술후각조병발증적발생솔、위험인소화처리방법。<br> 결과:연구표명파리체절제술후적주요병발증포괄안압승고、계발성청광안、각막병변、병발성백내장、파리체출혈、시망막탈리、의원성시망막렬공、전방삼출막、맥락막화첩상체탈리등。근거본조수거통계분석,인위단순파리체절제조、타성기체전충조화규유전충조발생각충술후병발증유명현차이。기중,타성기체전충조화규유전충조술후안압승고화계발성청광안적발생솔명현고우단순파리체절제조,우기시타성기체전충조술후고안압적발생솔경고。타성기체전충조화규유전충조술후병발각막병변화병발성백내장적발생솔명현고우단순파리체절제조,이차여술후고안압밀절상관。파리체출혈、의원성시망막렬공、시망막탈리、전방삼출막、맥락막화첩상체탈리등병발증각분조지간무현저차이。<br> 결론:파리체절제술시치료엄중파리체시망막질병적유효방법,술후대부분환자시력도득도료불동정도적제고。단시술후병발증엄중영향료술후효과,여하제고수술기교,피면감소화급시정학적처리술후병발증시파리체시망막수술성공적관건,야시금후파리체절할술연구적중점,수요아문계속탐색화연구。
AIM: With the advancement of pars plana vitrectomy, especially the intraocular application of inert gases and silicone oil, many serious vitreoretinal diseases, such as vitreous hemorrhage, endophthalmitis, proliferative diabetic retinopathy etc. have received effective treatment. But it is undeniable that there are many complications after vitrectomy that have seriously affected patients'vision recovery. The aim of this study is to observe the incidence and pathogenesis of various complications after vitrectomy to provide some clinical references to avoid and reduce the incidence of complications. <br> METHODS: This paper retrospectively analyzed records of 200 cases that underwent vitrectomy operated by the same surgeon. Inert gasesor silicone oil was filled accordingly. According to filling agent, patients were divided into simple vitrectomy group, inert -gas tamponade group and silicon -oil tamponade group;according to ocular hypertension onset, patients were divided into normal intraocular pressure group and ocular hypertension group; according to age, patients were divided into ≥50 group and <50 group.Relative analysis was made on the incidence, dangerous factors and management of complications in each group after vitrectomy. <br> RESULTS: According to the study, the major postoperative complications of vitrectomy were increase of introculr tension, secondary glaucoma, corneal diseases, complicated cataract, vitreous hemorrhage, retinal detachment, iatrogenic retinal hole, fibrin formation in anterior chamber, choroid and ciliary body detachment, and so on.According to statistical analysis of data of this group, it was believed that there were obvious differences among simple vitrectomy group, inert-gas tamponade group, silicon-oil tamponade group in postoperative complications.The postoperative incidence of increase of introculr tension and secondary glaucoma in inert-gas tamponade group and silicon-oil tamponade group were obviously higher than that in simple vitrectomy group.What's more, in inert-gas tamponade group, the postoperative incidence of ocular hypertension was much higher.The postoperative incidence of corneal complications and complicated cataract in inert -gas tamponade group and silicon-oil tamponade group were obviously higher than that in simple vitrectomy group and closely correlated with postoperative ocular hypertension. There were no distinct differences among every group in vitreous hemorrhage, iatrogenic retinal hole and retinal detachment, fibrin formation in anterior chamber, choroid and ciliary body detachment. <br> CONCLUSION:Vitrectomy is an important and effective treatment method for serious vitreoretinal diseases and most patients have obtained different visual improvement after the surgery. But postoperative complications seriously affect postoperative effect. The key to the success of vitreous retinal surgery in the future is that how to improve surgical techniques to avoid, reduce and timely dispose postoperative complications.It is also the emphasis of research of vitrectomy which deserves more exploration and research.