自制套管联合预置缝线在硅油取出术中的应用  

Homemade Cannula Combined with Preset Stitches in Application of Silicone Oil Removal

作　　者：刘明[1] 龙潭[1] 刘轩[2] 崔丽珺[2] 谢安明[2] 陈丽[2] 

机构地区：[1]西安市第一医院眼科,西安710001 [2]西安交通大学医学院第一附属医院眼科,西安710061

出　　处：《解放军医药杂志》2016年第11期84-87,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：国家自然科学基金资助(81300765)

摘　　要：目的评价用头皮针自制套管联合预置缝线23 G灌注、用于硅油取出术的有效性和安全性。方法回顾性分析97例改良自制套管行硅油取出术的临床效果。经结膜预置缝线后,在缝线之间做23 G微套管系统灌注,上方做穿刺口。将头皮针末端链接注射器后,剪除留有末端5~8 mm制成取油套管,套管头端扩大至刚好包住23 G套管。利用手动抽取玻璃体腔硅油,术后缝合巩膜穿刺口,并拉紧预置缝线后拔出23 G微套管。结果 97例眼均顺利完成了硅油取出术,硅油取出完全。术后的最佳矫正视力（log MAR视力）较术前有所改善,差异有统计学意义（P〈0.05）;手术后1 d、3个月的眼内压值分别较术前降低（P〈0.05）;手术时间：单纯行硅油取出术18~40（21.7±7.1）min;合并白内障摘除及人工晶体植入术35~72（45.3±15.9）min;合并二期人工晶体睫状沟植入术29~52（35.9±11.7）min。结论利用预置缝线及头皮针自制套管行硅油取出术具有安全、经济、快捷等优点。Objective To investigate efficacy and safety of scalp heedle homemade cannula combined with 23-gauge（23-G） infusion of preset stitches in application of silicone oil removal（SOR）.Methods Clinical effects of 97patients（97 eyes） underwent SOR by improved homemade cannula were retrospectively analyzed.After conjunctival preset suture,23-G infusion were performed between sutures,and puncture part was on above.The end of scalp heedle was connected with a syringe,and cut from the end with 5-8mm left to make cannula,and then casing headend was enlarged to encase 23-G cannula fitly.Intraocular silicone oil was proactive removed using manual extraction,and sclerotic puncture part was sutured,and then 23-G infusion cannula was pulled out after tightening preset stitches after surgery.Results SOR was performed successfully for 97 eyes,and the assessments of postoperative best corrected visual acuity（logMAR visual acuity） were improved compared with those before surgery,and the differences were statistically significant（P〈0.05）.Intraocular pressure（IOP） values of 1 d and 3 months after operation were significant lower compared with those before surgery（P〈0.05）.Only SOR time was 18-40（21.7 ± 7.1） min; cataract removal combined with intraocular lens implantation was 35-72（45.3 ± 15.9） min; SOR combined with secondary iol ciliary groove implantation was 29-52（35.9 ± 11.7） min.Conclusion Scalp heedle homemade cannula combined with infusion of preset stitches in application of silicone oil removal is safe,economical and convenient.

关 键 词：眼内异物 硅油取出术 自制套管 23 G微创 预置缝线 

分 类 号：R779.14[医药卫生—眼科] R916.3[医药卫生—临床医学]