后段眼球内金属异物不同手术方式临床疗效分析  

Clinical analysis of different surgical methods for posterior segment intraocular metallic foreign bodies

作　　者：郑彦 陈佳娜 陈吉婷 赖钟祺 李学喜 Zheng Yan;Chen Jiana;Chen Jiting;Lai Zhongqi;Li Xuexi(Department of Ophthalmology,the 910th hospital of the people's liberation army of China,Quan Zhou 362000,China)

机构地区：[1]解放军联勤保障部队第910医院眼科,福建泉州362000

出　　处：《临床眼科杂志》2020年第5期452-455,共4页Journal of Clinical Ophthalmology

摘　　要：目的探讨治疗后段眼球内金属异物的不同手术方式和临床疗效。方法回顾性分析我院2016年1月至2018年12月收治后段眼球内金属异物82例(82只眼)。观察分析治疗后段眼球内金属异物的不同手术方式和治疗结果,及外伤性视网膜脱离的相关因素、治疗效果等。结果52例患者行一期23G玻璃体切除手术,异物取出成功率100%,30例患者行外路巩膜切开磁吸取异物手术,异物取出成功率90.00%,两组间比较差异有统计学意义(P<0.05)。两组患者术后视力较术前视力均有提高,差异有统计学意义(P<0.05)。两组视力改善率:内路组76.92%、外路组63.33%,内路组视力改善情况优于外路组。视网膜脱离26例,发生率31.71%,其发生与异物大小、损伤区域密切相关(P<0.05),所有视网膜脱离患者在8 h内行玻璃体切除手术,均成功复位。结论23G玻璃体切除手术治疗后段眼球内金属异物手术成功率高、视力改善率高,并在治疗外伤性视网膜脱离等方面疗效显著,值得推广。Objective To explore the clinical effects of different surgical methods in treating posterior segment intraocular metallic foreign bodies.Methods This was a retrospective case-series study.A total of 82 patients(83 eyes)with posterior segment intraocular metallic foreign bodies(from Jan,2016 to Dec,2018)were enrolled in the study.Different surgical methods and treatment effects of metallic foreign bodies in the posterior segment of eyeball,relevant factors and treatment effects for traumatic retinal detachment were analyzed.Results The successful rate of foreign body removal was 100%in the vitrectomy group(52 patients)and 90%in magnetic extraction group(30 patients).The difference between the two groups was statistically significant(P<0.05).The postoperative visual acuity of both groups was better than the preoperative visual acuity,and the difference was statistically significant(P<0.05).At the end of follow up the percentage of patients with good visual acuity outcome in the two groups was 76.92%and 63.33%,respectively.The visual acuity improvement of the vitrectomy group was better than the magnetic extraction group.The incidence of retinal detachment was 31.71%(26 cases).The retinal detachment incidence was correlated with the diameter of foreign body and the location of penetrating wound(P<0.05).All patients with retinal detachment were successfully treated after 23G vitrectomy within 8 hours.Conclusions 23G vitrectomy surgery for the treatment of metal foreign bodies in the posterior segment of the eye has a high success rate,high vision improvement rate,and significant effect in the treatment of traumatic retinal detachment,and thus is worth promoting.

关 键 词：23G玻璃体切除术 外路巩膜磁吸取异物术 眼球内异物 视网膜脱离 

分 类 号：R47[医药卫生—护理学]