动静脉鞘膜切开术治疗视网膜分支静脉阻塞  

Clinical observation of arteriovenous sheathotomy for treatment of retinal vein branch occlusion

作　　者：张静琳[1] 吕林[1] 李永浩[1] 吕秀兰[1] 李石毅[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《广东医学》2004年第5期489-491,共3页Guangdong Medical Journal

摘　　要：目的　观察动静脉鞘膜切开术 (arteriovenoussheathotomy)治疗视网膜分支静脉阻塞 (branchretinalveinocclusion ,BRVO)的临床疗效。方法　分析 1 9例行动静脉鞘膜切开术患者的术中所见 ,术前术后的视力、眼底彩照、眼底荧光造影 (fundusfluoresceinangiography,FFA)、光学相干断层扫描 (opticalcoherencetomography,OCT)、多焦视网膜电图 (multifocalelectroretinography ,mERG)等检查的临床资料。结果　术中 ,动静脉鞘膜切开后均可见近端视网膜静脉充盈增加。随访期间术前确诊BRVO的患者有 5例 (5 /1 0 )视力提高 ,术前为玻璃体出血的患者术后有8(8/9)例视力提高。眼底彩照、FFA发现视网膜出血明显吸收 ,血管变直 ,但有新的无灌注区出现。OCT显示黄斑水肿较术前明显减轻或消失。mERG显示黄斑区反应振幅明显高于术前。 1例患者因反复玻璃体出血再行手术。2例患者因视网膜脱离行硅油填充。 2例患者出现黄斑前膜。结论　动静脉鞘膜切开术是安全有效的手术 ,但仍不是彻底的病因治疗。ObjectiveTo evaluate the efficacy and indication of arteriovenous sheathotomy for treatment of branch retinal vein occlusion(BRVO). MethodsNineteen consecutive patients(19 eyes), underwent par plana vitrectomy, vitreous cortex separation and arteriovenous sheathotomy for BRVO. The follow-up period was 3～36 months. Postoperative examination including color fundus photography, fundus fluorescein angiography, optical coherence tomography and multifocal electroretinography were performed. ResultsIn all consecutive patients, the proximal retinal vein was found to be engorged when the adventitial sheath was dissected. All patients showed great clinical improvement following operation. Visual acuities were improved and the best-corrected visual acuity improved to 1 5. The retinal hemorrhage was significantly absorbed and macular edema disappeared or was dramatically reduced. One patient developed vitreous hemorrhage necessitating further surgery. Two patients developed retinal detachment. ConclusionArteriovenous sheathotomy is a safe and effective surgery for improving retinal branch occlusion.

关 键 词：动静脉鞘膜切开术 外科治疗 视网膜分支静脉阻塞 手术方法 

分 类 号：R774.1[医药卫生—眼科]