CAJ | 학술논문

目的中西医结合玻璃体腔内注气治疗黄斑出血,评价其有效性及安全性.方法对2007年1月至2014年4月在汕头大学第一附属医院眼科选取黄斑出血患者52例60只眼均行玻璃体腔内注气术治疗.术中前房穿刺放出0.1 ml房水,玻璃体腔内注入长效气体全氟丙烷(C3F8)0.3ml,指测眼压正常,光感明确.术后严格保持面向下体位1周以上.注气后观察视力变化、眼压和眼底等情况.术后5天开始予复方血栓通500 mg静滴.结果术后第一天可见40只眼(66.7％,40/60)出血灶移位至黄斑中心小凹以外,45只眼(75％,45/60)视力均有不同程度提高.矫正视力由治疗前的光感～0.3提高至指数～0.6,术后1周50只眼(83.33％,50/60)黄斑区积血部分吸收或视力有所提高,其中视力提高≥2行41只眼(68.33％,41/60),术后2周55只眼(91.67％,55/60)黄斑区积血明显吸收或移位至黄斑区以外,矫正视力提高至指数～1.00,其中视力提高≥2行46只眼(76.67％,46/60).术后第1天、术后第1周和术后第2周视力较术前均有明显提高,其差异有统计学意义(P＜0.05).结论玻璃体腔注气疗法是治疗黄斑出血的一种简单而有效的方法,对于单纯型黄斑出血、出血面积较小、早期出血者,尤其对外伤所致黄斑出血效果显著.联合使用复方血栓通,提高疗效,缩短病程.是能广泛在基层医院推广的治疗方式.
목적 중서의결합파리체강내주기치료황반출혈,평개기유효성급안전성.방법 대2007년1월지2014년4월재산두대학제일부속의원안과선취황반출혈환자52례60지안균행파리체강내주기술치료.술중전방천자방출0.1 ml방수,파리체강내주입장효기체전불병완(C3F8)0.3ml,지측안압정상,광감명학.술후엄격보지면향하체위1주이상.주기후관찰시력변화、안압화안저등정황.술후5천개시여복방혈전통500 mg정적.결과 술후제일천가견40지안(66.7％,40/60)출혈조이위지황반중심소요이외,45지안(75％,45/60)시력균유불동정도제고.교정시력유치료전적광감～0.3제고지지수～0.6,술후1주50지안(83.33％,50/60)황반구적혈부분흡수혹시력유소제고,기중시력제고≥2행41지안(68.33％,41/60),술후2주55지안(91.67％,55/60)황반구적혈명현흡수혹이위지황반구이외,교정시력제고지지수～1.00,기중시력제고≥2행46지안(76.67％,46/60).술후제1천、술후제1주화술후제2주시력교술전균유명현제고,기차이유통계학의의(P＜0.05).결론 파리체강주기요법시치료황반출혈적일충간단이유효적방법,대우단순형황반출혈、출혈면적교소、조기출혈자,우기대외상소치황반출혈효과현저.연합사용복방혈전통,제고료효,축단병정.시능엄범재기층의원추엄적치료방식.
Objective To evaluate the efficacy and safety of intravitreal gas injection in treatment of macular hemorrhage with combination of Chinese traditional and Western medicine.Methods Selection of macular hemorrhage in 52 cases (60 eyes) underwent intravitreal gas injection treatment.Intraoperative anterior chamber puncture released 0.1ml aqueous humor,intravitreal injection of long-acting gas perfluoropropane (C3F8) 0.3ml,the intraocular pressure measurement was normal,light projection clear.Postoperative strictly kept the body position for more than 1 week.After gas injection to observe the changes of visual acuity,intraocular pressure and ocular fundus were observed.On the fifth days postoperative,the compound Xueshuantong intravenous infusion of 500rag was given.Results One day postoperative,hemorrhage position displaced away from the fovea centralis in 40 eyes (66.7％,40/60),vision improved in 45 eyes (75％,45/60).The corrected visual acuity improved from LP (Light Perception)-0.3 preoperative to CF (Counting Fingers)-0.6.One week postoperative,50 eyes (83.33％,50/60) of macular hemorrhage partly absorbed or visual acuity improved including in 41 eyes (68.33％,41/60),and the visual acuity improved ≥2 lines.Two weeks postoperative,55 eyes (91.67％,55/60) of macular hemorrhage was significantly absorbed or hemorrhage position displaced away from the fovea centralis.Corrected visual acuity improved to CF to 1.0,including in 46 eyes (76.67％,46/60) the visual acuity improved ≥2 lines.On 1 day,1 week and 2 weeks postoperative visual acuity was increased obviously,the difference was statistically significant (P ＜0.05).Conclusions Intravitreal gas injection therapy is a simple and effective method for the simple type of macular hemorrhage,macular hemorrhage,small area bleeding,early bleeding,especially for traumatic macular hemorrhage.The combined use of compound Xueshuantong can improve the efficacy,shorten the course of disease.It can be widely popularized in basic level hospital treatment.