急性症状性马蹄形裂孔治疗的时机与方式  

Timing and skills of treatment for acute symptomatic horse-shoe retinal tears

作　　者：郭浩轶[1] 董应丽[1] 郭希让[1] 陈瑞合[2] 宋学英 

机构地区：[1]河南省眼科研究所,郑州450003 [2]漯河市中心医院 [3]平顶山市152医院

出　　处：《中国实用眼科杂志》2008年第10期1052-1054,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察急性症状性马蹄形裂孔预防治疗的临床效果，探讨适宜时机与方式。方法回顾性的分析患急性症状性马蹄形裂孔者，接受预防性治疗的92例（92只眼），观察所获预防性治疗的临床效果，以不同病程、不同术式和不同技术分组统计，分析并进行比较性研究。结果（1）行预防治疗的92例中未发生视网膜脱离者79例（85．87％），其中激光光凝70例，未发生视网膜脱离者58例（82．86％），22例采用巩膜外冷凝术，21例（95．45％）获愈。应用冷凝技术作预防性治疗比应用光凝技术的治疗效果要好（x^2=98．8，19〈0．001）。（2）全组共13例（14．13％）发生了视网膜脱离，其中8例在治疗后的2～5d发生（61．54％），最长为42d。（3）预防性光凝失败的12例中，9例（75％）为病程〈1周，其余3例为3-6周。（4）近期（病程〈1周）发生的裂孔36例中，21例即行一次性密集包绕式光凝，有8例发生视网膜脱离（38．1％），15例采用分期半环绕式光凝，仅有1例发生视网膜脱离（6．67％）。结论马蹄形裂孔初发期是诱发视网膜脱离的敏感时段，遵循个体化治疗原则采用光凝辅以适宜的术前及术后处理可提高预防效果。Objective To observe the clinical effects of preventive treatment tbr acute symptomatic horse-shoe retinal tears.The suitable opportunity and the skill were discussed.Method Ninty-two cases （92 eyes）suffered acute symptomatic horse-shoe retinal tears accepts the preventive treatment,the clinical effect were analyzed retrospectively.The results of the different disease course, treatment method and techniques were compared.Results （ 1 ）Ninty-two cases （92 eyes）accept the preventive treatment, in which 79 cases （85.87%） sealed the tear successfully.Laser photocoagulation for 70 cases,58 cases （82.86%）succeed.Trans-scleral cryotherapy for 22 cases,21cases （95.45%）succeed.Cryotherapy is superior to photocoagulation for prevent treat the horse-shoe tear. （x^2=98.8,P 〈0.001）. （2）Altogether 13 cases （14.13%）developed into retinal detachment after treatment.,（mong them 8 cases （61.54%）happened in 2-5 days,the latest is 42 days.（3 ）In 12 cases who failed with photocoagulation, the disease course of 9 cases （75%）were less than 1 week, the others were 3-6 weeks.（ 4 ）In 36 cases whose tear formed within 1 weeks, 21 cases accept photocoagulation in routine way（ the tears surrounded by densely laser spot for one time ）, 8 （38.1%）of them retinal detached.Fifteen cases accept photocoagulation in different way（ large and sparse laser spot, posterior edge were sealed firstly, anterior edge were sealed after 3-5 days）, only 1 cases （6.67%）of them formed retinal detachment.Conclusion Acute symptomatic horse-shoe tears was easy to induced retinal detachment.Following the individuation principle of treatment can improve the preventive effects.

关 键 词：马蹄形裂孔 预防性治疗 临床分析 治疗方法 

分 类 号：R774.13[医药卫生—眼科] R720.597[医药卫生—临床医学]