镇静下新生儿视网膜前出血YAG激光治疗分析  

Analysis of YAG laser for the treatment of neonatal preretinal hemorrhage under sedation

作　　者：汤雪娥[1] 彭小凡[1] 傅丽萍 杨志浩[1] 谢东文[1] 黄晓英 TANG Xue’e;PENG Xiaofan;FU Liping;YANG Zhihao;XIE Dongwen;HUANG Xiaoying(Department of Otology,the Central Hospital of Xinyu Iron and Steel Group Co.,Ltd.,Jiangxi Xinyu 338000,China)

机构地区：[1]新余钢铁集团有限公司中心医院五官科,江西新余338000

出　　处：《上海医药》2021年第9期33-35,共3页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的 :观察镇静下YAG激光玻璃体后皮质切开引流术治疗新生儿黄斑区视网膜前出血的临床效果。方法 :选取黄斑区视网膜前出血新生儿45例(46眼),出生后4周时在镇静状态下采用YAG激光行玻璃体后皮质切开引流术。术后随访3个月,记录患眼出血吸收、视力改善和并发症发生情况。结果 :42例(42眼)出血缓慢引流入玻璃体腔,3例(4眼)因出血凝集引流失败。成功引流的42眼中,术后1周85.71%(36/42)的患眼视网膜前出血基本吸收,成功暴露黄斑中心凹,83.33%(35/42)的患眼明显追光,64.29%(27/42)的患眼明显追物;至术后3个月时,均能明显追光追物。引入玻璃体积血1~3周吸收,无玻璃体积血情况发生。结论 :镇静下YAG激光辅以体位引流新生儿视网膜前出血,可有效改善患眼的追光反应,无严重并发症发生。Objective:To observe the clinical curative effect of YAG laser posterior vitreous cortex(PVC)incision and drainage under sedation on neonatal preretinal hemorrhage in macular area.Methods:Forty-five neonates(46 eyes)with preretinal hemorrhage in macular area were enrolled and underwent PVC by YAG laser under sedation four weeks after birth.They were followed up for 3 months after surgery.The hemorrhage absorption of affected eyes,visual acuity improvement and complications were recorded.Results:There were 42 cases(42 eyes)with hemorrhage and slow drainage into vitreous cavity,and 3 cases(4 eyes)with drainage failure due to hemorrhage agglutination.Among 42 eyes with successful drainage,preretinal hemorrhage of 85.71%(36/42)of affected eyes were basically absorbed at one week after surgery,with successful exposure of macular fovea,83.33%(35/42)of affected eyes with significant light following,64.29%(27/42)of them with significant objects following.At 3 months after surgery,all could significantly follow light and objects.After the vitreous introduced,hemorrhage was absorbed after 1-3(1.87±0.54)weeks.There was no vitreous hemorrhage.Conclusion:The application of YAG laser assisted with postural drainage under sedation in neonatal preretinal hemorrhage can effectively improve light following response of affected eyes without serious complications.

关 键 词：黄斑区 视网膜前出血 新生儿 钇铝石榴石激光 

分 类 号：R779.7[医药卫生—眼科] R722.19[医药卫生—临床医学]