20G和23G联合玻璃体切割术的短期疗效分析  

Short-term efficacy analysis of 20G and 23G combined vitrectomy

作　　者：杨一涛[1] 

机构地区：[1]菏泽市立医院眼科,山东省菏泽市274000

出　　处：《眼科新进展》2014年第10期950-953,共4页Recent Advances in Ophthalmology

摘　　要：目的 探讨２０Ｇ和２３Ｇ联合玻璃体切割术治疗玻璃体视网膜疾病的临床疗效。方法 本研究为前瞻性临床研究，将首次行玻璃体切割术的玻璃体视网膜疾病患者９９例９９眼纳入研究，利用随机数字表法将患眼随机分为传统２０Ｇ玻璃体切割组（Ａ组）、经结膜２０Ｇ玻璃体切割组（Ｂ组）、２０Ｇ和２３Ｇ联合玻璃体切割组（Ｃ组），每组各３３眼。观察各组患者行玻璃体切割术的手术时间，术后１ｄ、３ｄ、７ｄ术眼的舒适度，术后１周的矫正视力、眼压及并发症等情况。结果 各组手术前后矫正视力比较，差异有统计学意义（均为Ｐ＝０．０００），各组之间手术前后视力差异无统计学意义（均为Ｐ＞０．０５）。各组手术时间比较，Ａ、Ｂ、Ｃ各组的手术时间分别为８０～１３５ｍｉｎ、６５～１１５ｍｉｎ、６４～１００ｍｉｎ，Ａ组与Ｂ、Ｃ两组之间比较，差异有显著统计学意义（Ｐ＝０００３、０．００２）。Ｂ、Ｃ两组之间进行比较，差异无统计学意义（Ｐ＝０．１２）。各组患者术后不同时间点术眼舒适度进行比较，Ａ组与Ｂ、Ｃ两组分别比较，差异均有显著统计学意义（均为Ｐ＜０．０１），Ｂ、Ｃ两组之间进行比较，差异无统计学意义（均为Ｐ＞０．０５）。术后１周内，患者的眼压为（１４．２５±３．１８）ｍｍＨｇ（１ｋＰａ＝７．５ｍｍＨｇ），术后不同时间点，各组患者无一例发生低眼压等并发症。术后并发症各组之间比较，差异无统计学意义（均为Ｐ＞０．０５）。结论 ２０Ｇ和２３Ｇ联合玻璃体切割手术，手术安全高效，操作简便易行，易于推广和使用。Objective To investigate the therapeutic effects of 20G and 23G combined vitrectomy for vitreoretinal diseases. Methods Prospective clinical study. Ninty-nine eyes of 99 vitreoretinal patients carried vitrectomy for the first time included in this study, the affected eye were randomly divided into three groups using random number table method postoperatively：Group A （33 eyes, treated by traditional 20G vitrectomy）, group B （33 eyes, treated by transconjunctival 20G vitrectomy）, group C （33 eyes, treated by 20G and 23 G combined vitrectomy）. The duration of surgery, comfort of eye on the first day after surgery, and corrected visual acuity, intraocular pressure and complications at one week after surgery were observed in each group. Results There were significant differences in corrected visual acuity before and after surgery of each group （ all P = 0. 000）, but there was no statistical difference between each group （ all P 〉 0.05 ）. The operation time of group A, B, C were 80 - 135 minutes, 55 - 115 minutes, 54 -100 minutes, respectively, there were significant differences between group A and group B, C （P = 0. 003,0.002 ）, but there was no statistical difference between group B with group C（P =0.12）. There were significant differences in comfort of eye on the first day after surgery between group A and group B, C （ all P 〈 0.01 ）, but there was no statistical difference between group B with group C（P 〉 0.05 ）. IOP at one week after surgery in each group was （ 14.25 ± 3.18 ） mmHg （ 1 kPa = 7.5 mmHg）, no complication such as low pressure in group A, B, C at different time points after surgery was occurred. There was no statistical difference in complications at one week after surgery between each group （P 〉 0.05）. Conclusion 20G and 23G combined vitrectomy is safety and efficiency, and is easy to operation and use.

关 键 词：玻璃体切割术 联合手术 对比研究 

分 类 号：R779.6[医药卫生—眼科]