| 许超,刘光辉,王松田.不同时间窗玻璃体切割术在开放性眼外伤中的应用效果分析[J].中国烧伤创疡杂志,2021,(3):193~196. |
| DOI： |
| 中文关键词: 玻璃体切割术 开放性眼外伤 视力矫正 视网膜 玻璃体脱离 |
| 英文关键词:Vitrectomy Open ocular trauma Vision correction Retina Vitreous body detachment |
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| 中文摘要: |
| 【摘要】 目的 分析不同时间窗玻璃体切割术在开放性眼外伤中的应用效果? 方法 选取 2016年1月至2019年1月焦作市人民医院收治的65例开放性眼外伤患者作为研究对象, 并根据玻璃体切割术实施时机将其分为早期治疗组(33 例) 与常规治疗组(32 例), 其中早期治疗组于伤后6 d内行玻璃体切割术, 常规治疗组于伤后7 ~ 14 d行玻璃体切割术, 对比两组患者末次随访时最佳矫正视力变化情况, 视网膜复位情况以及玻璃体再出血?继发性青光眼? 外伤性增生性玻璃体视网膜病变(tPVR)等并发症发生情况? 结果 末次随访时, 早期治疗组视力明显提高15例? 稍有提高13例? 无提高5例, 明显优于常规治疗组视力明显提高 10 例?稍有提高10例? 无提高9例? 下降3例(Z =-1.916, P = 0.045);早期治疗组视网膜复位成功31例? 失败2例, 与常规治疗组视网膜复位成功29例?失败3例无明显差异( χ 2 = 0.251, P =0.616); 早期治疗组发生硅油依赖2例? 玻璃体再出血3例? 继发性青光眼1例? tPVR 2 例, 明显少于常规治疗组发生硅油依赖 4 例? 玻璃体再出血3例? 继发性青光眼5例? tPVR 7 例(χ 2 = 9.859, P =0.002)? 结论 开放性眼外伤特别是合并视网膜脱离的开放性眼外伤患者早期行玻璃体切割术可有效恢复光学通路透明性, 提高视力恢复程度, 降低 tPVR 等并发症的发生风险, 在眼部情况及身体状况均符合手术条件的情况下尽早行玻璃体切割术具有较高的临床应用价值? |
| 英文摘要: |
| 【Abstract】Objective To analyze the application effect of vitrectomy in treating open ocular traumas at different time windows. Methods Sixty-five patients with open ocular traumas, admitted to Jiaozuo People's Hospital from January 2016 to January 2019, were selected as research subjects. According to the timing of vitrectomy, the subjects were divided into an early treatment group(33 cases) and a conventional treatment group(32 cases). Vitrectomy was performed within 6 days after injury in the early treatment group, while the operation was conducted within 7-14 days after injury in the conventional treatment group. Complications including changes of best corrected visual acuity, retinal reattachment, vitreous body rebleeding, secondary glaucoma, traumatic proliferative vitreoretinopathy(tPVR) during the last follow-up were compared between the two groups. Results During the last follow-up, the visual acuity of patients in the early treatment group was significantly improved in 15 cases, slightly improved in 13 cases, and without improvement in 5 cases, which was significantly better than 10 cases of significantly improved, 10 cases of slightly improved, 9 cases without improvement, and 3 cases of decreased in the conventional treatment group(Z=-1.916, P=0.045). There were 31 cases with successful retinal reattachment and 2 cases failed in the early treatment group. In contrast to 29 cases with successful retinal reattachment and 3 cases failed in the conventional treatment group, the difference was not statistically significant(χ2=0.251, P=0.616. In the early treatment group, 2 cases developed silicone oil dependence, 3 cases with vitreous body rebleeding, 1 case with secondary glaucoma, and 2 cases with tPVR, which was significantly superior to the corresponding 4 cases with silicone oil dependence, 3 cases with vitreous body rebleeding, 5 cases with secondary glaucoma and 7 cases with tPVR in the conventional treatment group(χ2=9.859, P=0.002). Conclusion For patients with open ocular traumas, especially when complicated with retinal detachment, performing vitrectomy at an early time after injury can help restore the transparency of the optical pathway in patients’ eyes, improve their vision recovery, and reduce the occurrence risk of complications including tPVR. If patients could meet the requirements of operation in terms of physical and vision conditions, early vitrectomy has a high value of clinical application. |
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