中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2015年
3期
161-164
,共4页
玻璃体视网膜手术%视野%止血%气液交换
玻璃體視網膜手術%視野%止血%氣液交換
파리체시망막수술%시야%지혈%기액교환
Vitreoretinal surgery%visual field%Hemostasis%Fluid-air exchange
目的 探讨联合气液交换下玻璃体视网膜手术治疗严重眼后段外伤的临床效果.方法 30例(30只眼)严重眼后段外伤,在联合气液交换下进行玻璃体视网膜手术,观察术中眼内操作情况、手术时长、术前术后视力、视网膜和脉络膜复位情况及术后并发症.术后随访6个月.结果 30例玻璃体视网膜手术操作均在联合气液交换下顺利完成,术中止血效果佳,视野清晰,手术时间为50～ 90 min,平均(62.84±10.15) min.术后眼B超检查,视网膜和脉络膜均复位.术后末次随访时眼底检查,27只眼视网膜复位佳,3只眼复位不良.术后角膜水肿9只眼,前房积血6只眼,前房炎性反应13只眼,继发性青光眼7只眼,视网膜前或视网膜下增生26只眼,硅油依赖眼8只眼.术后视力无光感2只眼,光感4只眼,手动11只眼,数指及以上13只眼,术后视力较术前显著提高,差异有统计学意义(x2=24.79,P=0.000).结论 采用联合气液交换下玻璃体视网膜手术提高了术中视野清晰度,便于术中止血,顺利完成手术.并为严重眼后段外伤的进一步治疗创造了条件,避免了眼球摘除.
目的 探討聯閤氣液交換下玻璃體視網膜手術治療嚴重眼後段外傷的臨床效果.方法 30例(30隻眼)嚴重眼後段外傷,在聯閤氣液交換下進行玻璃體視網膜手術,觀察術中眼內操作情況、手術時長、術前術後視力、視網膜和脈絡膜複位情況及術後併髮癥.術後隨訪6箇月.結果 30例玻璃體視網膜手術操作均在聯閤氣液交換下順利完成,術中止血效果佳,視野清晰,手術時間為50～ 90 min,平均(62.84±10.15) min.術後眼B超檢查,視網膜和脈絡膜均複位.術後末次隨訪時眼底檢查,27隻眼視網膜複位佳,3隻眼複位不良.術後角膜水腫9隻眼,前房積血6隻眼,前房炎性反應13隻眼,繼髮性青光眼7隻眼,視網膜前或視網膜下增生26隻眼,硅油依賴眼8隻眼.術後視力無光感2隻眼,光感4隻眼,手動11隻眼,數指及以上13隻眼,術後視力較術前顯著提高,差異有統計學意義(x2=24.79,P=0.000).結論 採用聯閤氣液交換下玻璃體視網膜手術提高瞭術中視野清晰度,便于術中止血,順利完成手術.併為嚴重眼後段外傷的進一步治療創造瞭條件,避免瞭眼毬摘除.
목적 탐토연합기액교환하파리체시망막수술치료엄중안후단외상적림상효과.방법 30례(30지안)엄중안후단외상,재연합기액교환하진행파리체시망막수술,관찰술중안내조작정황、수술시장、술전술후시력、시망막화맥락막복위정황급술후병발증.술후수방6개월.결과 30례파리체시망막수술조작균재연합기액교환하순리완성,술중지혈효과가,시야청석,수술시간위50～ 90 min,평균(62.84±10.15) min.술후안B초검사,시망막화맥락막균복위.술후말차수방시안저검사,27지안시망막복위가,3지안복위불량.술후각막수종9지안,전방적혈6지안,전방염성반응13지안,계발성청광안7지안,시망막전혹시망막하증생26지안,규유의뢰안8지안.술후시력무광감2지안,광감4지안,수동11지안,수지급이상13지안,술후시력교술전현저제고,차이유통계학의의(x2=24.79,P=0.000).결론 채용연합기액교환하파리체시망막수술제고료술중시야청석도,편우술중지혈,순리완성수술.병위엄중안후단외상적진일보치료창조료조건,피면료안구적제.
Objective To evaluate the clinical outcomes of the vitreoretinal surgery combined with fluid-air exchange for severe posterior segment ocular trauma.Methods Thirty eyes of 30 cases of severe posterior segment ocular trauma were involved in this study.Vitreoretinal surgery combined with fluid-air exchange were performed on these eyes.The intraocular conditions during the surgeries,the operating time,the pre-and postoperative visual acuity,retinal and choroidal reattachment,and postoperative complications were recorded.The patients were followed up for 6 months.Results The operations of vitreoretinal surgery combined with fluid-air exchange were performed successfully in all 30 eyes which provided effective condition of hemostasis and clear surgical field.The operation time ranged from 50 to 90 minutes,mean (63.84 ± 11.13) min.B-scan ultrasonography were taken after operation and showed that the retina and choroid became reattached in all cases.The last follow-up examination of the fundus after the surgery showed that retinal reattachment succeeded completely in 27 eyes but in 3 eyes incompletely.Postoperative complications included corneal edema in 9 eyes,hypema in 6 eyes,anterior chamber inflammation in 13 eyes,secondary glaucoma in 7 eyes,epiretinal membranes or subretinal proliferation in 26 eyes,and so-called silicone oil dependency in 8 eyes.The visual acuity was no light perception in 2 eyes,light perception in 4 eyes,handmovement in 6 eyes,and counting finger or better in 8 eyes.The postoperative visual acuity was significantly better than the preoperative one,and the difference was statistically significant (x2 =24.79,P =0.000).Conclusion The vitreoretinal surgery combined with fluid-air exchange could provide convenient surgical field and facilitate hemostasis,which is an improved technique for the treatment of severe posterior segment ocular trauma in order to avoid evisceration of the eye.
