黄斑裂孔主流术式的术后体位管理  

Positioning management after macular hole mainstream vitrectomy

作　　者：杨萌 庞少芳 胡博杰 Yang Meng;Pang Shaofang;Hu Bojie(Tianjin Medical University School of Optometry,Tianjin Medical University Eye Institute,Tianjin Medical University Eye Hospital,Tianjin 300384,China)

机构地区：[1]天津医科大学眼科医院、天津医科大学眼科研究所、天津医科大学眼视光学院,300384

出　　处：《国际眼科纵览》2023年第3期283-288,共6页International Review of Ophthalmology

摘　　要：黄斑裂孔主流术式玻璃体切除联合内界膜剥除及玻璃体腔气体填充术对患者术后体位有所要求,如面朝下体位(face-down position,FDP)等特殊体位。对术后体位的选择及监测方式的研究有助于患者提高依从性,增加正确体位时间,减少不良体位时间。如何在保证黄斑裂孔闭合率的前提下减少FDP时间或其他可代替FDP的体位与术式是研究的重点。裂孔>400μm的特发性黄斑裂孔患者术后严格保持一定时间的FDP是术后标准的护理过程。裂孔<400μm时术后非仰卧位与FDP相比对裂孔闭合率的影响尚无明确结论。目前FDP体位监测仪包括Maculog电子设备、连接耳机的弧形夹具头位监测仪、头部固定式传感器、带传感器的粘贴式眼罩等;对于非仰卧位监测有滚球型传感器与倾斜开关式头位监测装置、可实时视听反馈的可穿戴无线定位传感器等,可对患者术后体位起到提醒与记录作用。一些研究采用术中及术后OCT检查指导FDP的持续时间。The majority of macular hole surgery,vitrectomy combined with internal limiting membrane peeling and vitreous cavity gas filling,require special postoperative positions,such as face-down position(FDP).The study of postoperative position selection and monitoring can help improve patient compliance,increase the time in the correct position and reduce the time in a poor position.How to reduce the FDP time or develope other positions and procedures that can replace FDP while ensuring the macular hole closure rate is the focus of the study.Strict maintenance of FDP for a certain period is the standard postoperative care procedure for patients with macular hole>400μm.The effect of postoperative non-supine position compared with FDP on the rate of hole closure when the macular hole is<400μm has not been concluded.Current FDP position monitors include Maculog electronic device,curved fixture head position monitor connected to headphones,head fixed sensor,and adhesive eye mask with the sensor.For non-supine position monitoring,there are roll ball type sensors with tilt switch type head position monitoring devices,and wearable wireless positioning sensor with real-time audio-visual feedback,which can serve as a reminder and record of patient's postoperative position.Some studies have used intraoperative and postoperative OCT examinations to guide the duration of FDP.

关 键 词：黄斑裂孔 体位选择 体位监测 

分 类 号：R779.6[医药卫生—眼科]