CAJ | 학술논문

目的：探讨脉络膜上腔出血（ SCH）的处理方法和规范SCH的诊疗思路。方法采用回顾性病例研究设计，分析2005年5月至2013年7月因内眼手术并发SCH患者10例（10只眼）的临床资料，分析发生SCH的原因。所有患者均给予全身及眼局部药物治疗，有手术指征者施行后巩膜切开术和／或玻璃体切除术，分析治疗方法及效果。本组患者中5只眼SCH发生于术中，5只眼发生于术后1～3 d。3只眼施行巩膜切开术引流脉络膜上腔积血联合玻璃体切除术；7只眼行单纯药物治疗。结果治疗后9只眼脉络膜上腔积血完全吸收。治疗后视力提高者8只眼，视力无变化者1只眼，失明1只眼。5只眼合并视网膜脱离均复位。1只眼有青光眼。5例患者合并高血压病。结论 SCH发病急骤，术中立即关闭切口，术后给予对症治疗，大部分患者脉络膜上腔积血可以自行吸收。术后发生SCH者可根据出血范围及合并症选择药物治疗或巩膜切开术。早发现、早预防可以有效降低SCH的发生率。
목적：탐토맥락막상강출혈（ SCH）적처리방법화규범SCH적진료사로。방법채용회고성병례연구설계，분석2005년5월지2013년7월인내안수술병발SCH환자10례（10지안）적림상자료，분석발생SCH적원인。소유환자균급여전신급안국부약물치료，유수술지정자시행후공막절개술화／혹파리체절제술，분석치료방법급효과。본조환자중5지안SCH발생우술중，5지안발생우술후1～3 d。3지안시행공막절개술인류맥락막상강적혈연합파리체절제술；7지안행단순약물치료。결과치료후9지안맥락막상강적혈완전흡수。치료후시력제고자8지안，시력무변화자1지안，실명1지안。5지안합병시망막탈리균복위。1지안유청광안。5례환자합병고혈압병。결론 SCH발병급취，술중립즉관폐절구，술후급여대증치료，대부분환자맥락막상강적혈가이자행흡수。술후발생SCH자가근거출혈범위급합병증선택약물치료혹공막절개술。조발현、조예방가이유효강저SCH적발생솔。
Objective To investigate the treatments and clinics ideas of SCH.Methods The study was retro-spective research.From May 2005 to July 2013, 10 patients complicated with SCH in intraocular surgery.Author analyze the reasons of the occurrence of SCH.All patients were treated with systemic and ocular medication;patients with indica-tions of surgery were applied to implementation of the scleral incision and /or vitrectomy, treatment and effect analysis. Five patients occurred SCH in surgery, five occurred after 1 ~3 d.3 patients were adopted by scleral incision and drain-age of choroidal hemorrhage combined with vitrectomy; other 7 was not applied with surgery.Results After treatment, choroidal hemorrhage of 9 patients were completely absorbed.After treatment, visual acuity of 8 patients improved, one was no change in vision, and one was blindness.5 cases with retinal detachment were reset.One was glaucoma.5 patients were hypertension.Conclusion SCH occurs abruptly, in surgery, Suturing surgical incision immediately, applying giving symptomatic treatment, most patients with choroidal hemorrhage may be self-absorbed.Medicines and/or sclerotomy could be optional according to the amount of bleeding and other ocular complication.Early detection and prevention can reduce the incidence of the SCH.