最小量巩膜扣带术与传统巩膜扣带术治疗视网膜脱离的比较  

Comparison of effect between minimal sclearal buckling and traditional scleral buckling for rhegmatogenous retinal detachment

作　　者：刘盛春[1] 钟凌[1] 余海江[1] 

机构地区：[1]宜宾市第一人民医院眼科,四川644000

出　　处：《中华眼外伤职业眼病杂志》2016年第1期56-59,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的比较最小量巩膜扣带术与传统巩膜扣带术治疗孔源性视网膜脱离的效果。方法最小量巩膜扣带术40例（40眼）作为A组，随机选择同期的传统巩膜扣带术40例（40眼）作为B组（对照组）。A组采用冷凝及硅海绵节段性垫压，B组行巩膜穿刺放液，冷凝，硅橡胶垫压，联合或不联合环扎。术后随访比较两组的视力提高率、视网膜复位率、复位所需时间、手术持续时间及并发症情况。结果A、B两组视力提高率分别为70．0％和62．5％，视网膜首次复位率分别为82．5％和87．5％，复位所需时间分别为（2．12±1．43）d和（1．77±1．14）d，三项数据两组间差异均无统计学意义（P=0．478、0．531、0．755）。手术持续时间A组为（51．70±7．63）rain，B组为（77．58±11．61）min，两组间差异有统计学意义（P=0．013）。A组并发症5例，4例为术后高眼压，1例为硅海绵暴露；B组并发症14例，包括术中眼内出血2例，术后高眼压8例，硅橡胶暴露1例，葡萄膜炎2例，两组间差异有统计学意义（P=0．032）。结论两种手术治疗孔源性视网膜脱离成功率相似，最小量巩膜扣带术手术操作时间较短，损伤小，并发症少，因而更易于被术者和患者所接受。Objective To compare the curative effect between minimal scleral buckling and traditional scleral buckling for rhegmatogenous retinal detachment. Methods Forty eyes of 40 patients with rhegmatogenous retinal detachment accepted minimal scleral buckling were taken as group A. Another 40 eyes of 40 patients underwent traditional scleral buckling were chose randomly as group B （control group）. Group A were treated with scleral cryocoagulation and silicone sponge segmental buckling, and group B underwent scleral paraeentesis, cryocoagulation, silicone rubber buckling, combined with or without scleral encircling. The visual acuity improving rate, retinal reattachment rate and its time spent, operation duration, and complications of the two groups were compared after operation. Results The visual acuity improving rate was 70.0% in group A and 62.5% in group B. Retinal reattachment rate was 82.5% in group A and 87.5% in group B. Reattachment time spent was （2.12 ＋ 1.43）d in group A and （1.77 ＋ 1.14）d in group B. There were no statistically differences between the two groups in all above aspects（ P = 0. 478,0. 531, O. 755）. Operation duration was （51.70 ~7.63）min in group A and （77.58 ＋ 11.61 ）min in group B, and the difference was significant statistically （ P = 0. 013 ）. Complications occurred in 5 cases in group A, including 4 cases of postoperative high intraocular pressure and 1 case of silicone sponge exposure. While it occurred 13 cases in group B, including 2 cases of intraoperative intraocular hemorrhage, 8 cases of postoperative high intraocular pressure, 1 case of silicone rubber exposure and 2 cases of uveitis. The difference was significant statistically （ P = 0. 032 ）. Conclusion Both the two kinds of operation have similar success rate for the treatment of rhegmatogenous retinal detachment, but the minimal scleral buckling surgery is more valuable in less operation time spending, less injuries and less complications.

关 键 词：视网膜脱离 孔源性 巩膜扣带术 最小量 效果 比较 

分 类 号：R779.6[医药卫生—眼科]