助手协作四通道双手操作在增生性糖尿病视网膜病变手术中的应用  

Four port bimanual vitrectomy with help of assistant in proliferative diabetic retinopathy

作　　者：胡博杰[1] 程朝晖[1] 刘巨平[1] 邵彦[1] 李筱荣[1] 

机构地区：[1]天津医科大学眼科中心,天津市300070

出　　处：《眼科新进展》2011年第6期577-578,581,共3页Recent Advances in Ophthalmology

摘　　要：目的通过观察助手协作四通道双手操作在增生性糖尿病视网膜病变手术中的应用,与传统的三通道后部玻璃体手术相比较,分析其可行性及安全性。方法本研究为前瞻性、随机对照临床试验。29例(30眼)增生性糖尿病视网膜病变患者随机分为研究组15例(15眼)与对照组14例(15眼);对照组应用传统的三通道后部玻璃体切割手术,研究组应用四通道后部玻璃体手术联合双手操作。记录数据包括:手术剥膜时间,医源性视网膜裂孔的数目,术前与术后第6个月的最佳矫正视力等。结果术后第6个月:研究组最佳矫正视力>0.1者5眼,对照组为2眼;末次随访时:研究组>0.1者6眼,对照组2眼。手术剥膜时间研究组为(14.36±4.48)min,对照组为(22.14±6.06)min,研究组与对照组相比差异有统计学意义(P=0.036)。研究组医源性视网膜裂孔的数目较对照组也明显减少。结论助手协作四通道双手操作在增生性糖尿病视网膜病变手术中减少剥膜时间、医源性视网膜裂孔,在没有第四光源等高端仪器设备的情况下,应用安全可行。Objective To investigate the efficacy and safety of 4-port bimanual vitrectomy illuminated with assistants by comparing with traditional 3-port pars plana vitrectomy in proliferative diabetic retinopathy（PDR）.MethodsA prospective and randomized controlled trial was taken.About 29 cases（30 eyes）with PDR were randomly divided into 2 groups.The control group（14 cases,15 eyes）was undergone 3-port pars plana vitrectomy;The experimental group（15 cases,15 eyes）were undergone 4-port vitrectomy with bimanual techniques.The time of peeling membrane,numbers of iatrogenic,intraocular tamponade,the best corrected visual acuity before surgery and at the 6th month after surgery,and postoperative complications were recorded.ResultsAt the 6th month after surgery,best corrected visual acuity more than 0.1 was 5 eyes in experimental group and 2 eyes in control group.For the last following up time,visual acuity more than 0.1 were 6 eyes in experimental group and 2 eyes in control group.The time of peeling membrane were（14.36±4.48）minutes in experimental group and（22.14± 6.06）minutes in control group（P=0.036）.Numbers of iatrogenic holes was less in experimental group than in control group.ConclusionsFour-port bimanual vitrectomy can reduce the time of peeling membrane and the number of iatrogenic hole.Even without the developed machine,the application is safe and effective.

关 键 词：助手协作 双手操作 玻璃体切割术 糖尿病视网膜病变 

分 类 号：R774.1[医药卫生—眼科]