两种自制简易装置取出玻璃体硅油的方法  

Two methods of vitreous silicone oil extraction with self-made simple devices

作　　者：栾国刚 谌金金 严涛 LUAN Guogang;CHEN Jinjin;YAN Tao(Department of Ophthalmology,Yichang Aier Eye Hospital,Yichang 443000,Hubei,China;Department of Ophthalmology,Yichang First People's Hospital/People's Hospital of Three Gorges University,Yichang 443003,Hubei,China)

机构地区：[1]宜昌市爱尔眼科医院眼科,湖北宜昌443000 [2]宜昌市第一人民医院/三峡大学人民医院眼科,湖北宜昌443003

出　　处：《山东大学耳鼻喉眼学报》2023年第1期80-84,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的 探讨自制研发用于玻璃体硅油取出两种简易装置的可行性。方法 选取因孔源性视网膜脱离、视网膜附着稳定的患者200例200眼,硅油填充术后3~6个月。采用完全随机化分组分为2个组。第一组有102例,20G通道20GY型静脉留置套管针制作简易取油器具取硅油,20G笛针行气液交换取出残余硅油;第二组98例,将输血管直管两端垂直剪断,保留长度为5 mm,一端套在23G取油穿刺套管上,另一端连接20 mL注射器取油,23G笛针行气液交换取出残余硅油;结果 第一组与第二组在硅油取出时间长度的比较差异无统计学意义[(4.65±1.52)min vs(4.85±2.02)min,t=1.38,P=0.14];第一组与第二组间气液交换时间的比较差异有统计学意义[(1.25±0.51)min vs(2.16±1.24)min,t=8.34,P=0.003];第一组与第二组间的眼压在术前及术后1 d、4 d、1周、1个月等时间的比较差异无统计学意义(P>0.05);第一组与第二组间在感染率、出血率、视网膜脱离复发率等并发症之间的比较差异无统计学意义(P>0.05);第一组患者的硅油残留率低于第二组患者,两组间的比较差异有统计学意义(5.10%vs 19.61%,P=0.002);结论 行单纯硅油取出,两种取油方法均是安全有效的。但气液交换时间及硅油残留率,20G Y型静脉留置针制作取油器联合20G笛针更有优势。Objective This study aimed to investigate the feasibility of using two simple devices for vitreous silicone oil extraction. Methods Overall, 200 eyes of 200 patients with rhegmatogenous retinal detachment and stable retinal attachment after silicone oil filling for 3-6 months were selected. The patients were randomly divided into two groups. Group one composed of 102 patients who were treated with 20G Y intravenous indwelling trocar to make a simple oil-extracting device to get silicone oil by 20G channel. Subsequently, a 20G flute needle was used for gas-liquid exchange to remove residual silicone oil. Group two composed of 98 patients. The two ends of the straight blood transfusion tube were vertically cut with a retention length of 5 mm. One end was set on the 23G oil extraction cannulas and the other end was connected with a 20 mL syringe for oil extraction. The 23G flute needle was used for gas-liquid exchange to remove residual silicone oil. Results There was no significant difference in the removal time between groups one and two([4.65±1.52] min vs [4.85±2.02] min, T=1.38, P=0.14). There was a significant difference for the gas-liquid exchange time between groups one and two([1.25±0.51] min vs [2.16±1.24] min, T=8.34, P=0.003). There was no significant difference in the intraocular pressure between the two groups preoperatively and postoperatively for 1 day, 4 days, 1 week, and 1 month(P>0.05). There were no significant differences in the infection rate, bleeding rate, and recurrence rate for retinal detachment between the two groups(P>0.05). The silicone oil residual rate in group one was lower than that in group two and was statistically different(5.10% vs 19.61%, P=0.002). Conclusion The two methods are safe and effective for silicone oil extraction. However, 20G Y vein indent needle combined with 20G flute needle is more advantageous in terms of the gas-liquid exchange time and silicone oil residual rate.

关 键 词：硅油取出 20G Y型静脉留置针 20、23G笛针 气液交换 并发症 

分 类 号：R774.1[医药卫生—眼科]