安徽医学
安徽醫學
안휘의학
ANHUI MEDICAL JOURNAL
2014年
10期
1352-1354,1355
,共4页
沈烨宇%唐于荣%万丽%刘文斌
瀋燁宇%唐于榮%萬麗%劉文斌
침엽우%당우영%만려%류문빈
玻璃体切割%内界膜剥离术%黄斑裂孔性视网膜脱落
玻璃體切割%內界膜剝離術%黃斑裂孔性視網膜脫落
파리체절할%내계막박리술%황반렬공성시망막탈락
Pars plana vitrectomy%Internal limiting membrane peeling%Macular hole retinal detachment
目的：观察并探讨玻璃体切割（pars plana vitrectomy，PPV）联合内界膜剥离术（internal limiting membrane peeling， ILMP）治疗黄斑裂孔性视网膜脱落（macular hole retinal detachment，MHRD）的有效性及安全性。方法选择MHRD患者64例，随机将患者分为观察组和对照组，每组各32例。对照组32例（32眼）接受PPV术，观察组32例（33眼）接受PPV联合ILMP治疗。术后随访6～12个月，记录患者的愈合、视力恢复及不良反应等情况。结果观察组视网膜复位率为93．9％（31/33），对照组复位率为75．0％（24/32），差异具有统计学意义（P＜0．05）；观察组视力改善率为81．8％（27/33），对照组为59．4％（19/32），两组相比差异具有统计学意义（P＜0．05）；两组术前平均最佳矫正视力（BCVA）相比，差异不具有统计学意义（P＞0．05），观察组治疗后3个月和6个月的BCVA明显高于对照组，差异具有统计学意义（P＜0．05）；随访过程中，观察组眼压升高和视野缺损并发症率明显低于对照组，差异具有统计学意义（P＜0．05）。结论 PPV联合ILMP术治疗有利于MHRD患者的视网膜解剖复位，对视力恢复具有显著的疗效，且安全可靠，是临床上治疗MHRD的较佳选择之一。
目的：觀察併探討玻璃體切割（pars plana vitrectomy，PPV）聯閤內界膜剝離術（internal limiting membrane peeling， ILMP）治療黃斑裂孔性視網膜脫落（macular hole retinal detachment，MHRD）的有效性及安全性。方法選擇MHRD患者64例，隨機將患者分為觀察組和對照組，每組各32例。對照組32例（32眼）接受PPV術，觀察組32例（33眼）接受PPV聯閤ILMP治療。術後隨訪6～12箇月，記錄患者的愈閤、視力恢複及不良反應等情況。結果觀察組視網膜複位率為93．9％（31/33），對照組複位率為75．0％（24/32），差異具有統計學意義（P＜0．05）；觀察組視力改善率為81．8％（27/33），對照組為59．4％（19/32），兩組相比差異具有統計學意義（P＜0．05）；兩組術前平均最佳矯正視力（BCVA）相比，差異不具有統計學意義（P＞0．05），觀察組治療後3箇月和6箇月的BCVA明顯高于對照組，差異具有統計學意義（P＜0．05）；隨訪過程中，觀察組眼壓升高和視野缺損併髮癥率明顯低于對照組，差異具有統計學意義（P＜0．05）。結論 PPV聯閤ILMP術治療有利于MHRD患者的視網膜解剖複位，對視力恢複具有顯著的療效，且安全可靠，是臨床上治療MHRD的較佳選擇之一。
목적：관찰병탐토파리체절할（pars plana vitrectomy，PPV）연합내계막박리술（internal limiting membrane peeling， ILMP）치료황반렬공성시망막탈락（macular hole retinal detachment，MHRD）적유효성급안전성。방법선택MHRD환자64례，수궤장환자분위관찰조화대조조，매조각32례。대조조32례（32안）접수PPV술，관찰조32례（33안）접수PPV연합ILMP치료。술후수방6～12개월，기록환자적유합、시력회복급불량반응등정황。결과관찰조시망막복위솔위93．9％（31/33），대조조복위솔위75．0％（24/32），차이구유통계학의의（P＜0．05）；관찰조시력개선솔위81．8％（27/33），대조조위59．4％（19/32），량조상비차이구유통계학의의（P＜0．05）；량조술전평균최가교정시력（BCVA）상비，차이불구유통계학의의（P＞0．05），관찰조치료후3개월화6개월적BCVA명현고우대조조，차이구유통계학의의（P＜0．05）；수방과정중，관찰조안압승고화시야결손병발증솔명현저우대조조，차이구유통계학의의（P＜0．05）。결론 PPV연합ILMP술치료유리우MHRD환자적시망막해부복위，대시력회복구유현저적료효，차안전가고，시림상상치료MHRD적교가선택지일。
Objective To observe and explore the effectiveness of pars plana vitrectomy(PPV)combined with internal limiting mem-brane peeling(ILMP)for patients with macular hole retinal detachment(MHRD).Methods Sixty-four patients with MHRD in the hospital from June 201 1 to August 2013 were selected and randomly divided into observation group and control group,with 32 cases in each group. The control group(32 eyes)accepted PPV surgery,while the observation group(33 eyes)received PPV combined with ILMP surgery.Patients were followed up for 6-12 months,and healing,visual acuity and adverse reactions in the two groups were observed and compared.Results Rate of retina reattachment of observation group and the control group was 93.9%(31/33)and 75.0%(24/32),respectively;the differ-ence was statistically significant (P<0.05).Rate of visual acuity improvement of the observation group and the control group was 81.8%(27/33)and 59.4% (19/32),respectively;there was statistically significant difference between two groups (P<0.05).The difference was not statistically significant in an average of preoperative best corrected visual acuity (BCVA)between two groups(P>0.05).BCVA af-ter 3 months and six months of treatment of the observation group was significantly higher than that of the control,and the difference was sta-tistically significant (P<0.05).In the follow-up process,the rate of increased intraocular pressure and visual field defect complications of the observation group was significantly lower,and the difference was statistically significant (P<0.05 ).Conclusion PPV combined with ILMP treatment in favor of the patient's anatomic MHRD on visual acuity has marked effect and security,which is one of the better choice in the clinical treatment of MHRD.
