CAJ | 학술논문

目的观察在局麻下行25G经结膜玻璃体切割术的疗效及适应证及时效性.方法回顾2010年10月至2012年1月53例住院患者,均为糖尿病视网膜病变玻璃体积血.其中玻璃体积血27只眼为传统的20G三通道经睫状体平坦部玻璃体切除手术；26只眼为25G经结膜玻璃体切割手术.对两组术中术后并发症、术后视力、眼部表现等进行对比分析.结果所有患者均较顺利完成手术操作；两组术后视力都有不同程度的改善,差异无统计学意义(P＞0.05).53例患眼中,20G组术中出现医源孔3例,经局部冷凝,眼内注入隋性气体后手术顺利完成.术后20G组出现再出血1例,经保守治疗后出血吸收,术后继发性青光眼两组各3例,经局部降眼压处理后改善.未发生感染性眼内炎、驱逐性脉络膜上腔出血等严重并发症,无1例患眼再手术.结论 25G经结膜玻璃体视网膜手术在轻症的糖尿病性玻璃体积血中具有可行性,手术操作简单、创伤小、并发症少、手术后恢复快等优点.
목적 관찰재국마하행25G경결막파리체절할술적료효급괄응증급시효성.방법 회고2010년10월지2012년1월53례주원환자,균위당뇨병시망막병변파리체적혈.기중파리체적혈27지안위전통적20G삼통도경첩상체평탄부파리체절제수술；26지안위25G경결막파리체절할수술.대량조술중술후병발증、술후시력、안부표현등진행대비분석.결과 소유환자균교순리완성수술조작；량조술후시력도유불동정도적개선,차이무통계학의의(P＞0.05).53례환안중,20G조술중출현의원공3례,경국부냉응,안내주입수성기체후수술순리완성.술후20G조출현재출혈1례,경보수치료후출혈흡수,술후계발성청광안량조각3례,경국부강안압처리후개선.미발생감염성안내염、구축성맥락막상강출혈등엄중병발증,무1례환안재수술.결론 25G경결막파리체시망막수술재경증적당뇨병성파리체적혈중구유가행성,수술조작간단、창상소、병발증소、수술후회복쾌등우점.
ObJective To observe the effect,indications and timeliness of 25G micro-invasion transconjunctival vitrectomy under local anesthesia.Methods Reviewed 53 patients in hospital from October 2010 to January 2012.All of the patients had diabetic retinopathy vitreous hemorrhage,27 eyes had vitrectomy for the traditional 20G three-channel ciliary body of the plain; 26 eye had vitrectomy for 25G the conjunctival vitrectomy.Complication,postoperative visual acuity and ocular onset presentation between two groups was comparatively analyzed and observed.Results The operations finished successfully on all of the eyes,Visual acuity of two groups had a different improvement,the difference had no statistical significance (P ＞0.05).In 53 sick eyes,3 eyes had the iatrogenic retinal tear during the operation in 20G group,the operation successfully completed by local condensing and intraocular injection of inert gas.One eye bleed again after the operation in 20G group,the blood had absorpted with conservative treatment.Three cases had glaucoma after operation in each group,the symptoms improved by local condensing.All the eyes had not occurred the serious complication of infectious endophthalmitis and suprachoroidal expulsive hemorrhage.All the patients had no operate again.Conclusions Diabetic retinopathy vitreous hemorrhage treated by vitreoretinal surgery using the 25G transconjunctival sutureless vitrectomy system has many advantages such as simple procedure,short operation time,micro-invasion,less complications and rapid recovery.