中华眼底病杂志
中華眼底病雜誌
중화안저병잡지
CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
2014年
5期
488-491
,共4页
吴鸣宇%刘玮%袁容娣%叶剑
吳鳴宇%劉瑋%袁容娣%葉劍
오명우%류위%원용제%협검
玻璃体切除术/方法%外科手术,微创性/副作用%硅油类
玻璃體切除術/方法%外科手術,微創性/副作用%硅油類
파리체절제술/방법%외과수술,미창성/부작용%규유류
Vitrectomy/methods%Surgical procedures,minimally invasive/adverse effects%Silicone oils
目的 对比观察改良式23G缝合切口硅油取出手术的临床疗效及安全性.方法 前瞻性临床研究.行硅油取出手术的临床连续病例177例180只眼纳入研究.其中,男性112例113只眼,女性65例67只眼;平均年龄(43.8±10.3)岁.平均硅油填充时间4.5个月.患者均行矫正视力、间接检眼镜、眼压、B型超声、光相干断层扫描(OCT)检查.患眼视网膜均在位.采用随机数字表法将患眼分为传统23G免缝合切口硅油取出手术组(A组)和改良式23G缝合切口硅油取出手术组(B组).分别为88、92只眼.两组患者性别(x2=1.596)、平均年龄、平均矫正视力(￡=0.785)、平均眼压(t=0.352)、原发疾病(x2=1.982)、晶状体状态(x2=2.605)比较,差异均无统计学意义(P＞0.05).手术结束时,记录手术时间.观察矫正视力、眼压硅油残留、脉络膜脱离、视网膜再脱离以及眼内炎等并发症发生情况.结果 A、B组平均手术时间比较,差异无统计学意义(t=1.950,P＞0.05).手术后1 d(t=0.873),1周(t=1.115),3个月(t=0.141)平均矫正视力比较,差异无统计学意义(P＞0.05).手术后1d,两组间平均眼压比较,差异有统计学意义(t=2.550,P＜0.05);手术后1周(t=1.451),3个月(t=1.062)平均眼压比较,差异均无统计学意义(P＞0.05).随访期间,A组患眼中发生低眼压、脉络膜脱离、玻璃体积血、视网膜再脱离和硅油残留小滴为25、8、5、9、7只眼,分别占A组患眼的28.4％、9.1％、5.7％、10.2％、8.0％;B组患眼为5、2、2、8、1只眼,分别占B组患眼的5.4％、2.2％、2.2％、8.7％、1.1％.两组患眼过一性低眼压、脉络膜脱离、硅油残留小滴发生率比较,差异有统计学意义(P＜0.05).随访中及末次随访时均未见眼内炎发生.结论 改良式23G缝合切口硅油取出手术可减少手术后低眼压、脉络膜脱离、残留硅油小滴等并发症的发生,安全性较好.
目的 對比觀察改良式23G縫閤切口硅油取齣手術的臨床療效及安全性.方法 前瞻性臨床研究.行硅油取齣手術的臨床連續病例177例180隻眼納入研究.其中,男性112例113隻眼,女性65例67隻眼;平均年齡(43.8±10.3)歲.平均硅油填充時間4.5箇月.患者均行矯正視力、間接檢眼鏡、眼壓、B型超聲、光相榦斷層掃描(OCT)檢查.患眼視網膜均在位.採用隨機數字錶法將患眼分為傳統23G免縫閤切口硅油取齣手術組(A組)和改良式23G縫閤切口硅油取齣手術組(B組).分彆為88、92隻眼.兩組患者性彆(x2=1.596)、平均年齡、平均矯正視力(￡=0.785)、平均眼壓(t=0.352)、原髮疾病(x2=1.982)、晶狀體狀態(x2=2.605)比較,差異均無統計學意義(P＞0.05).手術結束時,記錄手術時間.觀察矯正視力、眼壓硅油殘留、脈絡膜脫離、視網膜再脫離以及眼內炎等併髮癥髮生情況.結果 A、B組平均手術時間比較,差異無統計學意義(t=1.950,P＞0.05).手術後1 d(t=0.873),1週(t=1.115),3箇月(t=0.141)平均矯正視力比較,差異無統計學意義(P＞0.05).手術後1d,兩組間平均眼壓比較,差異有統計學意義(t=2.550,P＜0.05);手術後1週(t=1.451),3箇月(t=1.062)平均眼壓比較,差異均無統計學意義(P＞0.05).隨訪期間,A組患眼中髮生低眼壓、脈絡膜脫離、玻璃體積血、視網膜再脫離和硅油殘留小滴為25、8、5、9、7隻眼,分彆佔A組患眼的28.4％、9.1％、5.7％、10.2％、8.0％;B組患眼為5、2、2、8、1隻眼,分彆佔B組患眼的5.4％、2.2％、2.2％、8.7％、1.1％.兩組患眼過一性低眼壓、脈絡膜脫離、硅油殘留小滴髮生率比較,差異有統計學意義(P＜0.05).隨訪中及末次隨訪時均未見眼內炎髮生.結論 改良式23G縫閤切口硅油取齣手術可減少手術後低眼壓、脈絡膜脫離、殘留硅油小滴等併髮癥的髮生,安全性較好.
목적 대비관찰개량식23G봉합절구규유취출수술적림상료효급안전성.방법 전첨성림상연구.행규유취출수술적림상련속병례177례180지안납입연구.기중,남성112례113지안,녀성65례67지안;평균년령(43.8±10.3)세.평균규유전충시간4.5개월.환자균행교정시력、간접검안경、안압、B형초성、광상간단층소묘(OCT)검사.환안시망막균재위.채용수궤수자표법장환안분위전통23G면봉합절구규유취출수술조(A조)화개량식23G봉합절구규유취출수술조(B조).분별위88、92지안.량조환자성별(x2=1.596)、평균년령、평균교정시력(￡=0.785)、평균안압(t=0.352)、원발질병(x2=1.982)、정상체상태(x2=2.605)비교,차이균무통계학의의(P＞0.05).수술결속시,기록수술시간.관찰교정시력、안압규유잔류、맥락막탈리、시망막재탈리이급안내염등병발증발생정황.결과 A、B조평균수술시간비교,차이무통계학의의(t=1.950,P＞0.05).수술후1 d(t=0.873),1주(t=1.115),3개월(t=0.141)평균교정시력비교,차이무통계학의의(P＞0.05).수술후1d,량조간평균안압비교,차이유통계학의의(t=2.550,P＜0.05);수술후1주(t=1.451),3개월(t=1.062)평균안압비교,차이균무통계학의의(P＞0.05).수방기간,A조환안중발생저안압、맥락막탈리、파리체적혈、시망막재탈리화규유잔류소적위25、8、5、9、7지안,분별점A조환안적28.4％、9.1％、5.7％、10.2％、8.0％;B조환안위5、2、2、8、1지안,분별점B조환안적5.4％、2.2％、2.2％、8.7％、1.1％.량조환안과일성저안압、맥락막탈리、규유잔류소적발생솔비교,차이유통계학의의(P＜0.05).수방중급말차수방시균미견안내염발생.결론 개량식23G봉합절구규유취출수술가감소수술후저안압、맥락막탈리、잔류규유소적등병발증적발생,안전성교호.
Objective To compare the safety and efficacy of a modified 23G with suturing incision and traditional 23G vitrectomy for silicone oil removal.Methods A total of 177 patients (180 eyes) who underwent silicon oil removal (the average tamponade period was 4.5 months) were enrolled in this prospective study.The patients included 112 males (113) and 65 female (67).The mean age was (43.8±10.3) years.The corrected vision,indirect ophthalmoscopy,intraocular pressure,B-ultrasound and optical coherence tomography were measured for all patients.All patients had no complete retinal detachment.The patients were randomly divided into modified 23G with suturing incision group (group A,88 eyes) and traditional 23G vitrectomy (group B,92 eyes).The differences of sex (x2 =1.596),age,corrected vision (t=0.785),intraocular pressure (t=0.352),primary disease (x2 =1.982) and lens condition (x2 =2.605)were not significant (P＞0.05).The operation time,intraocular pressure,silicon oil retention,choroidal detachment,retinal redetachment and endoophthalmitis were recorded at the end of the operation.Results The difference of mean operation time was not significant between group A and B (t =1.950,P＞0.05).The differences of mean visual acuity 1 day,1 week and 3 months after operation were not significant between group A and B (t=0.873,1.115,0.141; P＞0.05).There was difference of mean intraocular pressure at 1 day after operation (t =2.550,P＜0.05),but not at 1 week and 3 months after operation (t =1.451,1.062; P＞0.05) between group A and B.There were 25 eyes (28.4％) with intraocular hypotension,8 eyes (9.1％) with choroidal detachment,5 eyes (5.7 ％) with vitreous hemorrhage,9 eyes (10.2 ％) with retinal redetachment,and 7 eyes (8.0％) with silicon oil retention in group A.There were 5 eyes (5.4％) with intraocular hypotension,2 eyes (2.2％) with choroidal detachment,2 eyes (2.2％) with vitreous hemorrhage,8 eyes (8.7 ％) with retinal redetachment,and 1 eye (1.1 ％) with silicon oil retention in group B.The differences of incidence of intraocular hypotension,choroidal detachment and silicon oil retention were significant (P＜0.05).No endoophthalmitis occurred.Conclusion The safety of modified 23G with suturing incision is better than traditional 23G vitrectomy for silicone oil removal,with decreased incidence of intraocular hypotension,choroidal detachment and silicon oil retention.
