视网膜内界膜翻转填塞联合自体血覆盖与空气填充对大孔径特发性黄斑裂孔的疗效对比  

Comparison of therapeutic effects of flipped filling of the inner limiting membrane of the retina combined with autologous blood coverage and air fi lling on large aperture idiopathic macular holes

作　　者：丁亚丽 王静 朱忠桥 黄磊 Ding Yali;Wang Jing;Zhu Zhongqiao;Huang Lei(Department of Ophthalmology,Xi’an People’s Hospital(Xi’an Fourth Hospital),Xi’an Shaanxi 710000,China;Department of Ophthalmology,Xianyang First People’s Hospital,Xianyang Shaanxi 712099,China)

机构地区：[1]西安市人民医院(西安市第四医院)眼科,陕西西安710000 [2]咸阳市第一人民医院眼科,陕西咸阳712099

出　　处：《中国医刊》2024年第11期1213-1216,共4页Chinese Journal of Medicine

基　　金：陕西省教育厅专项科研计划项目(20JK0421)。

摘　　要：目的对比分析视网膜内界膜翻转填塞联合自体血覆盖与空气填充治疗大孔径特发性黄斑裂孔(IMH)的临床效果。方法前瞻性选取2022年1月至2024年2月西安市人民医院眼科收治的120例大孔径(裂孔直径>400µm)IMH患者,采用随机数字表法随机分为对照组和观察组,每组60例。对照组行视网膜内界膜翻转填塞+空气填充治疗,观察组行视网膜内界膜翻转填塞+自体血覆盖治疗,比较两组的术后裂孔闭合率,术前和术后1个月、3个月的最佳矫正视力(BCVA),术前和术后3个月的视网膜外界膜(ELM)缺损直径、椭圆体带(EZ)缺损直径、黄斑裂孔(MH)直径,以及术后并发症发生情况。结果观察组术后裂孔闭合率(98.33%)高于对照组(85.00%),差异有统计学意义(P<0.05)。术前两组BCVA比较差异无统计学意义(P>0.05);术后1个月和3个月,两组BCVA均明显优于术前,且观察组明显优于对照组,差异有统计学意义(P<0.05)。术前两组ELM缺损直径、EZ缺损直径、MH直径比较差异无统计学意义(P>0.05);术后两组ELM缺损直径、EZ缺损直径、MH直径均明显低于术前,且观察组明显低于对照组,差异有统计学意义(P<0.05)。两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论采用视网膜内界膜翻转填塞联合自体血覆盖治疗大孔径IMH具有较好的临床效果,可改善患者视力,促进黄斑裂孔愈合。Objective To compare and analyze the clinical efficacy of retinal inner limiting membraneflipping packing combined with autologous blood coverage and airfilling in the treatment of large aperture idiopathic macular hole(IMH).Method A prospective selection was conducted on 120 patients with large aperture(fissure diameter>400µm)IMH admitted to the ophthalmology department of Xi’an People’s Hospital from January 2022 to February 2024.They were randomly divided into a control group and an observation group using a random number table method,with 60 patients in each group.The control group received treatment with retinal membraneflipping andfilling+airfilling,while the observation group received treatment with retinal membraneflipping andfilling+autologous blood coverage.The postoperative hole closure rate,best corrected visual acuity(BCVA)at 1 and 3 months before and after surgery,outer retinal membrane(ELM)defect diameter,ellipsoidal band(EZ)defect diameter,macular hole(MH)diameter,and incidence of postoperative complications were compared between the two groups.Result The postoperativefissure closure rate in the observation group(98.33%)was higher than that in the control group(85.00%),and the difference was statistically significant(P<0.05).There was no statistically significant difference in preoperative BCVA between the two groups(P>0.05);At 1 and 3 months after surgery,both groups showed significantly better BCVA than before surgery,and the observation group was significantly better than the control group,with a statistically significant difference(P<0.05).There was no statistically significant difference in ELM defect diameter,EZ defect diameter,and MH diameter between the two groups before surgery(P>0.05);After surgery,the ELM defect diameter,EZ defect diameter,and MH diameter in both groups were significantly lower than before surgery,and the observation group was significantly lower than the control group,with statistical significance(P<0.05).There was no statistically significant d

关 键 词：大孔径特发性黄斑裂孔 视网膜内界膜翻转填塞 自体血覆盖 空气填充 裂孔闭合率 

分 类 号：R774.5[医药卫生—眼科]