不同时期微创玻璃体切除术治疗伴有视网膜脱离的开放性眼外伤疗效分析  

Efficacy analysis of minimally invasive vitrectomy at different stages on open ocular trauma with retinal detachment

作　　者：张更华[1] ZHANG Geng-hua(Shenyang Fourth People’s Hospital,Shenyang 110000,China)

机构地区：[1]沈阳市第四人民医院,110000

出　　处：《中国实用医药》2021年第27期66-69,共4页China Practical Medicine

摘　　要：目的探讨不同时期微创玻璃体切除术治疗伴有视网膜脱离的开放性眼外伤的临床效果。方法66例(66眼)伴有视网膜脱离的开放性眼外伤患者,随机分为早期组和常规组,各33例(33眼)。早期组患者于眼睛受伤后6 d内接受Ⅱ期微创玻璃体切除术治疗,常规组患者于眼睛受伤后7~14 d接受Ⅱ期微创玻璃体切除术治疗。对比两组患者视网膜复位率、增殖性玻璃体视网膜病变(TPVR)发生率、视力恢复情况、术中并发症发生情况。结果早期组视网膜复位成功率90.9%高于常规组的69.7%,差异有统计学意义(P<0.05)。早期组TPVR发生率6.1%明显低于常规组的42.4%,差异有统计学意义(P<0.05)。早期组视力恢复情况优于常规组,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论对伴有视网膜脱离的开放性外眼伤患者通过适当提前手术时间能够有效避免TPVR的发生,可有效改善视力预后,促进视网膜复位,并提高手术治疗效果。Objective To discuss the clinical effect of minimally invasive vitrectomy at different stages on open ocular trauma with retinal detachment.Methods A total of 66 cases(66 affected eyes)of open ocular trauma with retinal detachment were randomly divided into early group and conventional group,with 33 cases in each group.Patients in the early group was treated with stageⅡminimally invasive vitrectomy within 6 d of eye injury,and patients in the conventional group was treated with stageⅡminimally invasive vitrectomy within 7-14 d of eye injury.The retinal reattachment rate,occurrence of traumatic prolifertive vitreoretinopathy(TPVR),vision recovery,and intraoperative complications were compared between the two groups.Results The success rate of retinal reattachment 90.91%in the early group was higher than 69.70%in the conventional group,and the difference was statistically significant(P<0.05).The incidence of TPVR in the early group was 6.1%,which was significantly lower than 42.4%in the conventional group,and the difference was statistically significant(P<0.05).The vision recovery of the early group was better than that of the conventional group,and the difference was statistically significant(P<0.05).The difference in complication rates between the two groups was not statistically significant(P>0.05).Conclusion In patients with open ocular trauma with retinal detachment,TPVR can be effectively avoided by appropriately advancing the time of surgery,which can effectively improve visual prognosis,promote retinal repositioning,and improve the outcome of surgical treatment.

关 键 词：微创玻璃体切除术 视网膜脱离 开放性眼外伤 

分 类 号：R779.6[医药卫生—眼科]