CAJ | 학술논문

目的：评估23G 经结膜无缝合玻璃体切除手术系统（23GTVS）联合非接触式广角镜在玻璃体积血手术治疗中的应用价值。方法选择2010年1月—2012年6月在新疆喀什地区第一人民医院眼科住院行23G 经结膜无缝合玻璃体切除手术系统（23GTVS）联合非接触式广角镜治疗的玻璃体积血患者44例（44眼），观察临床疗效及安全性。结果44例（44只眼）手术均顺利完成，手术时间16～60 min，平均手术时间36 min。除1例拔除灌注管时切口渗漏严重而缝合1针外，其余患者切口及巩膜穿刺口均闭合良好无需缝合。44眼视力：术前视力＜0．1者42眼，0．1～0．25者2眼，术后随访2～24个月，视力＜0．1者16眼，0．1～0．5者27眼，≥0．5者1眼；术后末次视力随访，视力提高者占59．09％。术后眼压与术前眼压相比无明显变化。结论23GTVS 联合非接触式广角镜适用于各种病因引起的玻璃体积血的治疗，其具有手术时间短、术后恢复快、并发症少的优点，是一种安全有效的微创手术方法。
목적：평고23G 경결막무봉합파리체절제수술계통（23GTVS）연합비접촉식엄각경재파리체적혈수술치료중적응용개치。방법선택2010년1월—2012년6월재신강객십지구제일인민의원안과주원행23G 경결막무봉합파리체절제수술계통（23GTVS）연합비접촉식엄각경치료적파리체적혈환자44례（44안），관찰림상료효급안전성。결과44례（44지안）수술균순리완성，수술시간16～60 min，평균수술시간36 min。제1례발제관주관시절구삼루엄중이봉합1침외，기여환자절구급공막천자구균폐합량호무수봉합。44안시력：술전시력＜0．1자42안，0．1～0．25자2안，술후수방2～24개월，시력＜0．1자16안，0．1～0．5자27안，≥0．5자1안；술후말차시력수방，시력제고자점59．09％。술후안압여술전안압상비무명현변화。결론23GTVS 연합비접촉식엄각경괄용우각충병인인기적파리체적혈적치료，기구유수술시간단、술후회복쾌、병발증소적우점，시일충안전유효적미창수술방법。
Objective To evaluate the efficacy and safety of 23G minimally invasive vitreous cutting system in combination with non-contact wide angle lenses in the operative treatment of vitreous hemorrhages. Methods From January 2010 to June 2012,44 registered patients (44 eyes)were selected from the oph-thalmology department of the First People′s Hospital of Kashgar Region.The patients (26 males and 18 females),aging from 16 to 79 years,were enrolled in this clinical study.These patients suffered from some of these diseases:central retinal vein obstruction (9),retinal periphlebitis (5),diabetic retinopathy (7),traumatic vitreous hemorrhage (6),Terson syndrome (2)and idiopathic polypoidal choroidal vascu-lopathy (4).The follow-up time ranged from 2 to 24 months after surgery.Results All the operations (44 eyes)were performed successfully.The duration of the operation ranged from 16 to 60 minutes (36 minuteson average).All the incisions and iris perforation closed pretty well but one case,where sutured with one stitch was required because of the leakage after removing the tube.The pre-operation visual acuity of these 44 eyes:42 eyes<0.1,2 eyes ranged from 0.1-0.25.After operation,the visual acuity of these eyes:16 eyes <0.1,27 eyes ranged from 0.1-0.5,1 eye ≥0.5.According to the latest after surgery visual acuity check,59.09% of the patients'visual acuity was improved.As for intraocular pressure,there was no significant difference before and after.Conclusion The use of 23G minimally invasive vitreous cutting sys-tem in combination with non-contact wide angle lenses in the treatment of various kind of vitreous hemor-rhage can create favorable results with fewer complications,shorter operative time and faster postoperative recovery and proved to be safe and effective.