视网膜切开手术治疗涉及黄斑外伤出血性视网膜脱离的疗效观察  

Clinical efficacy of retinotomy for hemorrhagic retinal detachment associated with macular trauma

作　　者：吴娜[1] 张丽红[2] 王景凤[3] WU Na;ZHANG Lihong;WANG Jingfeng(Ophthalmology Department of Jilin Provincial People＇s Hospital,Changchun 130021,China;The Second Department of Internal Medicine;Department of Interventional Medicine,Jilin Cancer Hospital,Changchun 130012,China)

机构地区：[1]吉林省人民医院眼科,长春130021 [2]吉林省肿瘤医院内二科,长春130012 [3]吉林省肿瘤医院介入科,长春130012

出　　处：《中华灾害救援医学》2018年第10期568-571,共4页Chinese Journal of Disaster Medicine

摘　　要：目的探讨视网膜切开手术治疗涉及黄斑外伤出血性视网膜脱离的临床疗效。方法回顾性分析2015-01至2017-03吉林省人民医院眼科收治的涉及黄斑外伤出血性视网膜脱离72例(72只眼)患者的临床资料,根据手术方案不同将患者分为研究组(n=43)和对照组(n=29),研究组患者实施视网膜切开手术,对照组患者实施玻璃体切割手术。比较两组患者术中、术后不同时期的视网膜复位、视功能及并发症情况。结果 (1)两组术后视网膜复位情况比较,对照组视网膜脱离2例,研究组虽然出现视网膜前增殖膜6例,但无视网膜脱离患者,研究组明显优于对照组。(2)研究组治疗脱盲率为83.72%(36/43),高于对照组的41.38%(12/29),差异具有统计学意义(χ2=3.273,P=0.005)。(3)研究组的前房泥沙样陈旧性暗红色积血、眼压升高并发症发生率显著低于对照组,差异有统计学意义(P<0.05);研究组的视网膜前增殖膜并发症发生率高于对照组,但差异无统计学意义(P>0.05)。结论与玻璃体切割手术相比,视网膜切开手术预后效果较好,是治疗涉及黄斑外伤出血性视网膜脱离的一种较为理想的治疗方法。Objective The objective of this study was to investigate the clinical efficacy of retinotomy for hemorrhagic retinal detachment macular trauma. Methods Clinical data of 72 cases （72 eyes） undergoing hemorrhagic retinal detachment associated with macular trauma surgery in the ophthalmology department of Jilin Provincial People＇s Hospital from January 2015 to March 2017 were retrospectively analyzed. The patients were divided into research group （n=43） and control group （n=29） based on surgical schemes. The research group was given retinotomy, while the control group was treated by vitrectomy. The retinal reattachment, visual function and complications during and after surgery were compared between the two groups. Results （1） Retinal reattachment comparison： there were 2 cases of retina detachment patients in the control group, while 0 in the research group but 6 cases of pre-retinal proliferative membrane. （2） The blindness-free rate of the research group was 83.72% （36/43）, which was higher than that of the control group [41.38% （12/29）], and the difference was statistically significant （χ2=3.273, P=0.005）. （3） The incidences of old red blood in the anterior chamber and increased intraocular tension in the research group were higher than those in the control group, and the differences were statistically significant （P 〈0.05）; the incidence of epiretinal membrane in the research group was higher than that in the control group, and the difference was not statistically significant （P〉0.05）. Conclusions Compared with vitrectomy, retinotomy has a better prognosis and is an ideal treatment for retinotomy for hemorrhagic retinal detachment associated with macular trauma.

关 键 词：视网膜切开术 单纯玻璃体切割手术 黄斑 外伤 出血性视网膜脱离 

分 类 号：R779.6[医药卫生—眼科]