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不同时机行玻璃体切割术治疗开放性眼外伤疗效比较
Comparative Study of Clinical Efficacy of Performing Vitrectomy at Different Times in the Treatment of Open Ocular Trauma

夏　添.不同时机行玻璃体切割术治疗开放性眼外伤疗效比较[J].中国烧伤创疡杂志,2021,(6):405~408.

DOI：

中文关键词: 开放性眼外伤玻璃体切割术手术时机视网膜脱离增殖性玻璃体视网膜病变视网膜复位

英文关键词:Open ocular trauma Vitrectomy Timing of surgery Retinal detachment Proliferative vitreoretinop⁃athy Retinal reduction

基金项目:

作者	单位
夏　添	124010 辽宁盘锦，盘锦市中心医院眼科

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中文摘要:

【摘要】目的探讨开放性眼外伤患者行玻璃体切割术的最佳时机。方法选取2018年1月至2020年8月盘锦市中心医院眼科收治的138例开放性眼外伤患者作为研究对象，并按照随机数表法将其随机分为观察组和对照组，每组69例，观察组患者在伤后2～4 d实施玻璃体切割术，对照组患者在伤后10～14 d实施玻璃体切割术，对比两组患者眼球保留情况以及随访3个月时的临床疗效与玻璃体再积血、继发性青光眼、外伤性增生性玻璃体视网膜病变（tPVR）、感染、硅油依赖等并发症发生情况。结果观察组患者眼球保留率为97.1%，与对照组患者眼球保留率97.1%无明显差异（χ2=0.000，P=1.000）；术后随访3个月，观察组患者中功能治愈52例、解剖治愈12例、未愈5例，明显优于对照组患者的功能治愈33例、解剖治愈17例、未愈19例（Z=-3.570，P=0.000）；观察组患者术后并发症发生率为7.24%，明显低于对照组患者术后并发症发生率56.52%（χ2=38.571，P=0.000）。结论开放性眼外伤患者早期行玻璃体切割术有利于视网膜成功复位，提高术后治愈率及，降低玻璃体积血、继发性青光眼和tPVR等并发症发生率，术后转归效果更佳，值得临床推广应用。

英文摘要:

【Abstract】 Objective To explore the best time of performing vitrectomy in the treatment of open ocular trauma.Methods 138 patients with open ocular traumas,admitted to Panjin Central Hospital from January 2018 to August 2020,were enrolled and divided into observation group (n =69) and control group (n =69) using random number table. Patientsin observation group underwent vitrectomy on day 2 -4 after injury,and patients in control group underwent vitrectomy on day 10 -14 after injury. The eyeball retention rate,and clinical efficacy and such complications as vitreous secondary hem-atocele,secondary glaucoma,traumatic proliferative vitreoretinopathy (tPVR),infection,and silicone oil dependence at 3-month follow-up were compared. Results The eyeball retention rate in observation group was 97.10%,which was not significantly different from 97.10% in control group (χ2 =0.000,P =1.000); at 3-month follow-up,in observation group,52 cases were cured functionally,12 cases were cured anatomically,and 5 cases were not cured,which were significantly better than control group,in which 33 cases were cured functionally,17 cases were cured anatomically,and 19 cases were not cured (Z = -3.570,P <0.001); the incidence of postoperative complications in observation group was 7.24%,significantly lower than 56.52% in control group (χ2 =38.571,P <0.001). Conclusion Early vitrectomy for patients with open ocular trauma can facilitate retina reduction,improve the postoperative cure rate,reduce the incidence of complications such as vitreous hematocele,secondary glaucoma and tPVR,and realize a better postoperative prognosis,deserving to be promoted in clinical practice.