中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2014年
6期
708-711
,共4页
张楠%朱冬梅%张钊填%宫卫锋
張楠%硃鼕梅%張釗填%宮衛鋒
장남%주동매%장쇠전%궁위봉
特发性黄斑裂孔%面向下体位%端坐位%裂孔闭合率
特髮性黃斑裂孔%麵嚮下體位%耑坐位%裂孔閉閤率
특발성황반렬공%면향하체위%단좌위%렬공폐합솔
Idiopathic macular hole%Face-down position%Seated position%Macular hole closure rate
目的 比较特发性黄斑裂孔(IMH)术后分别行面向下体位及端坐位后在裂孔闭合率及视力恢复上的差别.方法 前瞻性随机对照临床研究.对2012年1～12月在郑州人民医院眼科连续接受微创玻璃体切割手术治疗的IMH患者46例(46只眼)纳入研究.其中,男性8例(8只眼)、女性38例(38只眼);平均年龄(55.7±7.3)岁,平均病程(8.9±2.6)个月;术前logMAR视力为0.89±0.23,裂孔直径为(565±236) μm.均采用Snellen视力表行矫正视力(CVA)检查,以及验光、裂隙灯下眼底镜检查和光相干断层扫描(OCT)检查.将小数视力换算成最小分辨角对数(logMAR)视力用于统计学分析.患者按入院日期奇、偶数顺序被随机分为两组,一组(P0)在术后行面向下体位;另一组(P1)在术后行端坐位,各组分别为23例(23只眼),持续时间均为7d,且不少于12 h/d.术后6个月时比较两组患者在裂孔闭合率及视力恢复上的差别.结果 P0组的裂孔闭合率为95.7％ (22/23),P1组的裂孔闭合率为65.2％ (15/23),两组比较差异具有统计学意义(x2=4.973,P=0.026).P0组与P1组术后logMAR视力分别为(0.48±0.27)及(0.69±0.42),两组比较差异无统计学意义(t=-2.010,P=0.052).结论 对于裂孔直径＞400 μm的IMH患者,术后严格面向下体位是保证裂孔高闭合率的重要因素,对于裂孔直径较小的IMH患者,可以视患者具体情况将面向下体位改为端坐位.
目的 比較特髮性黃斑裂孔(IMH)術後分彆行麵嚮下體位及耑坐位後在裂孔閉閤率及視力恢複上的差彆.方法 前瞻性隨機對照臨床研究.對2012年1～12月在鄭州人民醫院眼科連續接受微創玻璃體切割手術治療的IMH患者46例(46隻眼)納入研究.其中,男性8例(8隻眼)、女性38例(38隻眼);平均年齡(55.7±7.3)歲,平均病程(8.9±2.6)箇月;術前logMAR視力為0.89±0.23,裂孔直徑為(565±236) μm.均採用Snellen視力錶行矯正視力(CVA)檢查,以及驗光、裂隙燈下眼底鏡檢查和光相榦斷層掃描(OCT)檢查.將小數視力換算成最小分辨角對數(logMAR)視力用于統計學分析.患者按入院日期奇、偶數順序被隨機分為兩組,一組(P0)在術後行麵嚮下體位;另一組(P1)在術後行耑坐位,各組分彆為23例(23隻眼),持續時間均為7d,且不少于12 h/d.術後6箇月時比較兩組患者在裂孔閉閤率及視力恢複上的差彆.結果 P0組的裂孔閉閤率為95.7％ (22/23),P1組的裂孔閉閤率為65.2％ (15/23),兩組比較差異具有統計學意義(x2=4.973,P=0.026).P0組與P1組術後logMAR視力分彆為(0.48±0.27)及(0.69±0.42),兩組比較差異無統計學意義(t=-2.010,P=0.052).結論 對于裂孔直徑＞400 μm的IMH患者,術後嚴格麵嚮下體位是保證裂孔高閉閤率的重要因素,對于裂孔直徑較小的IMH患者,可以視患者具體情況將麵嚮下體位改為耑坐位.
목적 비교특발성황반렬공(IMH)술후분별행면향하체위급단좌위후재렬공폐합솔급시력회복상적차별.방법 전첨성수궤대조림상연구.대2012년1～12월재정주인민의원안과련속접수미창파리체절할수술치료적IMH환자46례(46지안)납입연구.기중,남성8례(8지안)、녀성38례(38지안);평균년령(55.7±7.3)세,평균병정(8.9±2.6)개월;술전logMAR시력위0.89±0.23,렬공직경위(565±236) μm.균채용Snellen시력표행교정시력(CVA)검사,이급험광、렬극등하안저경검사화광상간단층소묘(OCT)검사.장소수시력환산성최소분변각대수(logMAR)시력용우통계학분석.환자안입원일기기、우수순서피수궤분위량조,일조(P0)재술후행면향하체위;령일조(P1)재술후행단좌위,각조분별위23례(23지안),지속시간균위7d,차불소우12 h/d.술후6개월시비교량조환자재렬공폐합솔급시력회복상적차별.결과 P0조적렬공폐합솔위95.7％ (22/23),P1조적렬공폐합솔위65.2％ (15/23),량조비교차이구유통계학의의(x2=4.973,P=0.026).P0조여P1조술후logMAR시력분별위(0.48±0.27)급(0.69±0.42),량조비교차이무통계학의의(t=-2.010,P=0.052).결론 대우렬공직경＞400 μm적IMH환자,술후엄격면향하체위시보증렬공고폐합솔적중요인소,대우렬공직경교소적IMH환자,가이시환자구체정황장면향하체위개위단좌위.
Objective To compare the difference of outcomes of macular hole closure rate and vision recovery of face-down position and seated position after pars plana vitrectomy for idiopathic macular hole.Methods Randomized controlled trial study.Consecutive 46 patients with idiopathic macular hole (IMH) from January 2012 to October 2012 in the department of ophthalmology in People's Hospital of Zhengzhou were included and equally randomized to two groups for different positions after the surgery by the date of admission.Group P0 was assigned to have face-down position and group P1 was assigned to have seated position,both remained 7 days after surgery,not less than 12h/D.The mean of patients' age,duration,logMAR visual acuity and macular hole diameter were 55.7±7.3 years,8.9±2.6 months,0.89±0.23 and 565±236μm.All the patients were required to come back 6 months after surgery.Main outcomes were macular hole closure rate and postoperative visual acuity.Results The closure rates of group P0 and group P1 were 95.7％ (22/23) and 65.2％ (15/23),with statistical significance (x2=4.973,P =0.026).The postoperative logMAR visual acuities of group P0 and group P1 were 0.48±0.27 and 0.69±0.42,without statistical significance (t =-2.010,P=0.052).Conclusions For those patients with macular hole larger than 400μm,it is essential to remain enough face-down position in order to achieve ideal macular hole closure rate and vision recovery.But for those with smaller macular hole in size,seated position after surgery is permeable to have ideal prognosis.
