摘要
目的探讨微创玻璃体切除术对手术切口、手术并发症及手术时间的影响，并观察术后手术切口的变化。方法将2012年1～7月在天津市眼科医院就诊的120例患者分为A组和B组各60例，年龄18—65岁（平均年龄50．5岁）。病情诊断包括牵拉性视网膜脱离，特发性黄斑裂孔，糖尿病视网膜病变继发玻璃体积血，孔源性视网膜脱离，单纯玻璃体积血。两组患者年龄，性别，病情诊断等比较差异无统计学意义（P〉0．05），具有可比性。A组接受微创玻璃体切割术，B组接受20G玻璃体切割术。记录手术时间，手术切口渗漏、手术并发症、切口炎性反应、术后疼痛、住院时间，对相关记录指标进行统计学分析比较。结果A组和B组的手术时间分别为（55．2±9．8）min，（64．8±11．2）min，差异有统计学意义（P〈0．05）。切口炎性反应分别为7例和16例（P〈0．05）具有统计学意义。其余项目两组间无统计学意义（P〉0．05）。结论微创玻璃体切除手术，手术时间明显缩短，术后伤口局部炎性刺激症状轻微，眼内异物感较轻。术后视功能恢复快。而术前的充分准备，如术前应用抗生素，局部用聚维酮碘冲洗结膜囊，则最大限度的避免术后切口渗漏引起的低眼压和眼内炎的发生。术后护理则加强病情及切口的观察，对出现眼压升高的患者及时发现，及时处理，控制了眼压的持续性升高，减少了并发症的发生。
Objective To evaluate the effect of micro-invasive vitrectomy surgery on the incision healing, surgery dutation, complications and to observe the incision changes postoperatively. Methods Total of 120 patients aged from 18 to 65 （averaged age 50.5） years old was randomly allocated into 2 groups： group A （n=60）, group B （n=60）. The diagnosis included vitreous bleeding, retinal detachment, diabetes associated retinopathy, macula hole. Patients of group A accepted micro-invasive vitrectomy and group B received surgery through 20 gauge catheter. The incision changed including bleeding, healing or infection was recorded, as well as the duration of surgery, postoperative complications. Results The surgery duration of group A and B was 55.2±9.8min and 64.8±11.2min respectively （P 〈0.05）, and the frequencies of incision inflammatory reaction of group A and B was 7 and 16 respectively （P 〈0.05）. Conclusions Micro-invasive surgery leads to less inflammatory reactions of incision and can decrease the duration of surgery. Sufficient and systemic nursing measures such as antibiotics use and flushing conjunctive sac by povidone-iodine can decrease the risk of low IOP and endoophthalmitis caused by incision infection. Postoperative nursing should emphasis on observing the incision changes and IOP and treating with any complications quickly.
出处
《中国实用眼科杂志》
2016年第1期81-83,共3页
Chinese Journal of Practical Ophthalmology
