特发性黄斑裂孔术后俯卧位与自由体位患者裂孔闭合率的比较  

A comparison of face-down positioning with adjustable positioning for closure rates in macular hole surgery

作　　者：徐鑫彦 孙先勇 高荣玉 任建涛 黄旭东 Xu Xinyan; Sun Xianyong; Gao Rongyu; Ren Jiantao; Huang Xudong(Shandong Weifang Hospital, Weifang 261000, China)

机构地区：[1]潍坊眼科医院,山东潍坊261000

出　　处：《中国实用眼科杂志》2017年第10期970-973,共4页Chinese Journal of Practical Ophthalmology

基　　金：山东省自然科学基金项目（ZR2013HM108）

摘　　要：目的比较特发性黄斑裂孔行玻璃体切割联合内界膜剥除及C3F8填充术后采取持续俯卧位与自由体位的患者黄斑裂孔闭合率及患者术后舒适度，探讨患者术后体位的选择。方法收集我院2014年11月至2016年10月住院手术治疗的特发性黄斑裂孔患者138例153只眼，随机分为2组：A组：患者采取持续俯卧位，74例83只眼；B组：患者采取自由体位64例，70只眼。随诊观察1年，并对两组患者术后眼压、黄斑裂孔闭合率、最佳矫正视力及术后舒适度进行统计学分析。结果术后，A组64例（71只眼）出现高眼压，3例（3只眼）低眼压；B组59例（63只眼）出现高眼压，2例（2只眼）低眼压。统计学分析两组差异无统计学意义（P〉0.05）。术后A组患者黄斑裂孔均闭合，B组中2例术后低眼压的患者黄斑裂孔未闭合，两组差异无统计学意义（P〉0.05）。A、B两组患者术后视力变化也未发现差异有统计学意义（P〉0.05）。患者术后舒适度比较，B组患者高于A组，差异有统计学意义（P〈0.01）。结论对于术后眼压正常或轻度升高的患者，采取自由体位与持续俯卧位具有相似的黄斑裂孔的闭合率，且术后视力恢复情况相似。但自由体位患者有较高的术后舒适度。ObjectiveTo compare face-down positioning with adjustable positioning for closure rates and postoperative comfort of patients after full-thickness macular hole surgery, and determine whether adjustable positioning is noninferior to face-down positioning.MethodsOne hundred and thirty-eight cases （153 eyes） were observed from November 2014 to October 2016. All the cases were diagnosed with idiopathic macular hole, and underwent Pars Plana Vitrectomy with the Peeling of the Internal Limiting Membrane and Gas Tamponade. The intraocular pressure, closure rates of Macular holes, and best-corrected visual acuity （BCVA） were measured before and after operation. The comfort level of patients was also evaluated at day 7 after surgery. All data were analyzed by statistical analysis.ResultsSixty-four cases （71 eyes） in group A and fifty-nine cases （63 eyes） in group B appeared high intraocular pressure, and three cases （3 eyes） in group A and two cases （2 eyes） in group B appeared low intraocular pressure. Final analysis of all participants demonstrated equal closure rates in both groups （P 〉0.05）. The change of BCVA did not differ significantly between the two groups （P 〉0.05）. The comfort level of patients had significant difference between both groups （P 〈0.01）.ConclusionsAdjustable positioning is noninferior to face-down positioning in closure rates of macular holes and BCVA of patients after surgery, when intraocular pressure of visual acuity of patients after surgery, when intraocular pressure of patients is normal or slightly higher. However, the patients with adjustable positioning show more comfortable compared to those patients with face-down positioning.

关 键 词：特发性黄斑裂孔 俯卧位 自由体位 闭合率 舒适度 

分 类 号：R774.5[医药卫生—眼科]