玻璃体切割手术治疗视网膜血管疾病致玻璃体积血的最佳时机探讨  

Optimal Time of Vitrectomy Operation Treatment for Vitreous Hemorrhage Caused by Retinal Vascular Disease

作　　者：冯小志[1] 黎作为[1] 

机构地区：[1]广东省高州市人民医院,广东高州525200

出　　处：《深圳中西医结合杂志》2015年第1期13-15,共3页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：茂名市科技计划项目(2012163)

摘　　要：目的：探讨玻璃体切割手术治疗视网膜血管疾病致玻璃体积血的最佳时机。方法：将在本院行玻璃体切除术的玻璃体积血患者57例（62眼）,按照玻璃体积血时间分为3组：A组1个月内,共20只眼;B组1~3个月,共25只眼;C组3个月以上,共17只眼。比较各组患者视力恢复、术后并发症情况。结果 A组视网膜脱落比例显著低于B组和C组（P〈0.05）;B组视网膜脱落比例显著低于C组（P=0.000）;随着玻璃体积血时间的延长,视网膜脱落比例显著上升。A组术后平均视力显著高于B组和C组（P〈0.05）;B组平均视力显著高于C组（P=0.000）;随着术前玻璃体积血时间的延长,最终视力呈明显下降趋势。A组并发症发生率显著低于B组和C组（P〈0.05）;B组并发症发生率显著低于C组（P=0.000）;随着术前玻璃体积血时间的延长,术后并发症发生率显著上升。结论：对于积血吸收不完全、存在再次出血风险的玻璃体积血患者应该立即手术,以提高患者术后视力,降低手术并发症。Objective To explore the optimal timing of vitrectomy operation treatment for vitreous hemorrhage caused by retinal vascular disease. Methods 57cases（62eyes） of vitreous hemorrhage patients underwent vitrectomy accorded to the time of vitreous hemorrhage were divided into three groups： group A within 1 months,a total of 20 eyes; group B of 1 ~ 3 months,a total of 25 eyes;group C more than 3 months,a total of 17 eyes.Compared of visual acuity recovery,postoperative complications of three groups. Results A group of retinal detachment was signifi cantly lower than B group and the C group（χ2 = 8.038,41.197,P〈0.05）; B group of retinal detachment rate was lower than that in C group（χ2 = 14.487,P = 0.000）; with the prolonged time of vitreous hemorrhage,retinal detachment rate increased signifi cantly; A group average postoperative visual acuity was signifi cantly higher than that of B group and C group（t = 3.036,7.482,P〈0.05）; B group of average visual acuity was signifi cantly higher than the C group（t = 5.292,P = 0.000）; with the prolonged time of vitreous hemorrhage before operation,the fi nal visual acuity was decreased. The complication rate of A group was significantly lower than that of B group and C group（χ2 = 5.007,32.028,P〈0.05）; the complication rate in B group was signifi cantly lower than that of C group（χ2 = 12.869,P = 0.000）; with the prolonged time of vitreous hemorrhage,postoperative complication rate increased signifi cantly. Conclusion For the blood absorption is incomplete,risk of bleeding again patients,should immediately operation,in order to improve the visual acuity,reduce operation complication.

关 键 词：玻璃体切除术 视网膜血管疾病 玻璃体积血 

分 类 号：R779.6[医药卫生—眼科]