挫伤性玻璃体积血的手术时机与效果  

The surgical timing and effects for vitreous hemorrhage caused by ocular blunt trauma

作　　者：郭希让[1] 郭浩轶[1] 李蕴随[1] 田清芬[1] 董应丽[1] 赵朝霞[1] 黄爱国[1] 

机构地区：[1]河南省眼科研究所,郑州450003

出　　处：《中华眼科杂志》2003年第7期419-421,共3页Chinese Journal of Ophthalmology

摘　　要：目的　探讨挫伤性玻璃体积血的手术时机与效果。方法　对 116例 (116只眼 )挫伤性玻璃体积血患者分别采用药物治疗 46例 (46只眼 )和玻璃体手术治疗 70例 (70只眼 ) ,并对结果进行比较性研究和随诊观察。结果　玻璃体手术组患者术后 1个月 ,视力≥ 0 1者为 71 4 %;而非手术组患者药物治疗后 1个月 ,视力≥ 0 1者仅为 2 1 7%,两者差异有显著意义 (P <0 0 5 )。非手术组患者治疗后视力 >0 1者 10只眼 ,其中 7只眼是于受伤后 2周内恢复视力。手术组患者中 ,仅有 2 7 1%的患眼做单纯玻璃体切除术 ,70 9%的患眼行玻璃体切除联合其他术式 ;术后有 3只眼发生视网膜脱离 ,经再手术治愈。非手术组患者治疗过程中 ,有 14只眼发生视网膜脱离 ,11只眼接受手术治疗 ,8只眼治愈。结论　挫伤性玻璃体积血药物治疗观察的时间为伤后 2～ 3周 ,若无明显好转应及时选择玻璃体手术治疗。Objective To investigate the surgical timing and effects for vitreous hemorrhage caused by blunt ocular trauma. Method 116 eyes of vitreous hemorrhage caused by ocular blunt trauma were divided into two groups, non-vitrectomy group (46 eyes) and vitrectomy group (70 eyes). The treating results and follow-up results were compared. Results 50 of 70 eyes (71.4%) in vitrectomy group and 10 of 46 eyes(21.7%) in non-vitrectomy group achieved a visual acuity of 0.1 or better over a follow-up period of 1 month, which indicated a significant difference between two groups. In the non-vitrectomy group, visual acuity of 10 eyes were better than 0.1, 7 eyes (70.0%) of them improved within 2 weeks of injury. In surgery group, 27.1% underwent only vitrectomy and 70.9% needed combining with other manipulations. In vitrectomy group the retina detachment was found in 3 eyes (4.3%) post-operatively and were cured by second operation. In non-vitrectomy group, the retinal detachment was found in 14 eyes (30.4%) during the follow-up period, and 8 eyes (72.7%) of 11 eyes received operation were cured. Conclusion Early vitreous surgery can improve curative effect for vitreous hemorrhage caused by blunt ocular trauma when no improvement was observed after applied drugs 2-3 weeks.

关 键 词：挫伤 玻璃体积血 手术 眼损伤 玻璃体切除术 治疗 

分 类 号：R779.6[医药卫生—眼科]