暴发性脉络膜上腔出血的研究进展  

Advance in the study of expulsive suprachoroidal hemorrhage

作　　者：黄易 胡海坚 张旭[1] Huang Yi;Hu Haijian;Zhang Xu(Affiliated Eye Hospital of Nanchang University,Jiangxi Research Institute of Ophthalmology&Visual Sciences,Key Laboratory of Ophthalmology of Jiangxi Province,Nanchang 330006,China)

机构地区：[1]南昌大学附属眼科医院、江西省眼科疾病临床医学研究中心、江西省眼科学重点实验室,330006

出　　处：《国际眼科纵览》2022年第6期522-527,共6页International Review of Ophthalmology

基　　金：国家自然科学基金项目(81860170);江西省自然科学基金项目(20181ACG70010)。

摘　　要：暴发性脉络膜上腔出血(expulsive suprachoroidal hemorrhage,ESCH)是内眼手术少见的最严重并发症之一,可累及睫状体、玻璃体、视网膜,可致视力完全丧失。其发病机制尚不清楚,但与脉络膜组织成分及血供相关。既往研究表明,ESCH最重要的诱发因素之一是眼压突然下降,多出现于白内障、青光眼、玻璃体切除手术的术中及术后。眼部B超可诊断ESCH,并且可观察脉络膜上腔凝血液化的程度,这有助于明确手术时机。手术是ESCH最重要的治疗方式,早期行脉络膜上腔引流手术可挽救残存视力,但不同引流方式的效果存在争议。术前重视危险因素管理,术中谨慎操作,及时发现并有效处理可避免ESCH的严重后果。Expulsive suprachoroidal hemorrhage(ESCH)is a rare,but one of the most severe and frightening complication of intraocular surgery.It may involve the ciliary body,vitreous,and retina,and can cause complete loss of vision.The pathogenesis of ESCH is unclear,but it is related to choroid tissue composition and blood supply.Previous studies have shown that one of the most important triggers of ESCH is the sudden drop of intraocular pressure,which often occurs during and after cataract surgery,glaucoma surgery and vitrectomy.B-scan ultrasonography can diagnose ESCH and observe the degree of coagulation in the suprachoroidal space,which helps to determine the timing of surgery.Surgery is the most important treatment for ESCH,early suprachoroidal drainage can save the remaining vision,but the effectiveness of different drainage methods is controversial.ESCH can be effectively avoided by paying attention to the management of risk factors before surgery,careful operation during surgery and timely detection of suprachoroidal hemorrhage(SCH).

关 键 词：暴发性脉络膜上腔出血 

分 类 号：R779.6[医药卫生—眼科]