本文關(guān)鍵詞： 非外傷性視網(wǎng)膜脫離 玻璃體切割術(shù) 青少年　出處：《中南大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的 觀察青少年非外傷性視網(wǎng)膜脫離的臨床特征及玻璃體切割術(shù)后的長期效果。 方法 回顧性系列病例研究。收集我院眼科2005年11月至2007年12月間因除外傷外視網(wǎng)膜脫離而接受經(jīng)平坦部玻璃體切割術(shù)、年齡。718歲的49例(51眼)患者的臨床資料,對其長期預(yù)后及相關(guān)影響因素等情況進(jìn)行回顧性分析,并對其中有意義病例進(jìn)行相關(guān)討論。 結(jié)果 1)在本組病例中,患者初診年齡為6歲～18歲,以男性居多,男女比例約為3：1,高發(fā)年齡為16-18歲,占27.5%。 2)所有病例中,近視不伴其他病因12眼(23.5%),不明原因視網(wǎng)膜脫離17眼(33.3%),眼內(nèi)炎5眼(9.8%),色素層炎5眼(9.8%),家族性滲出性玻璃體視網(wǎng)膜病變3眼(5.9%),黃斑前膜以及黃斑裂孔2眼(3.9%),Coats病2眼(3.9%),曾行眼前節(jié)手術(shù)(晶體抽吸術(shù))2眼(3.9%),視網(wǎng)膜劈裂1眼(2.0%),視網(wǎng)膜靜脈周圍炎(Eales' disease)1眼(2.0%),以及Marfan綜合征1眼(2.0%)。 3)至隨訪結(jié)束為止,視網(wǎng)膜解剖復(fù)位率為86.3%,仍有7例(13.7%)患眼眼內(nèi)硅油未取出(即硅油眼)；共28例(54.9%)患眼術(shù)后視力較術(shù)前好轉(zhuǎn)(P=0.003),38例(74.5%)患眼現(xiàn)矯正視力較術(shù)后視力有所提高(P=0.008)；共20例(39.2%)患眼發(fā)生并發(fā)癥,其中并發(fā)性白內(nèi)障居首位。 4)影響青少年玻璃體切割術(shù)后視網(wǎng)膜解剖復(fù)位以及視功能恢復(fù)的主要因素有增殖性玻璃體視網(wǎng)膜病變,晶體狀態(tài),初診年齡,以及單純孔源性視網(wǎng)膜脫離。 結(jié)論 1.青少年非外傷性視網(wǎng)膜脫離的患者以男性居多,高發(fā)年齡為16-18歲,其中近視為主要病因。 2.經(jīng)平坦部玻璃體切割術(shù)在治療青少年非外傷性視網(wǎng)膜脫離時(shí)具有較高的成功率,但由于患兒的特殊性,手術(shù)的整體效果仍有待進(jìn)一步提高,治療方法以及術(shù)中硅油的使用也需進(jìn)一步研究。 3.影響青少年玻璃體切割術(shù)后視網(wǎng)膜解剖復(fù)位以及視力恢復(fù)的主要因素有增殖性玻璃體視網(wǎng)膜病變,晶體狀態(tài),初診年齡,以及單純孔源性視網(wǎng)膜脫離(P0.05)
[Abstract]:Purpose. To observe the clinical features of juvenile non-traumatic retinal detachment and the long-term effect after vitrectomy. Method. A retrospective series of case studies. The clinical data of 49 patients (51 eyes) who underwent flat vitrectomy for retinal detachment except trauma from November 2005 to December 2007 in our hospital were collected. The long-term prognosis and related influencing factors were analyzed retrospectively, and the significant cases were discussed. Results. 1) in this group, the first diagnosis age is 6 years old to 18 years old, the male is the majority, the male / female ratio is about 3: 1, the high incidence age is 16-18 years old (27.555). 2) of all cases, Myopia was not associated with other etiology in 12 eyes (23. 5%), unexplained retinal detachment in 17 eyes (33. 3%), endophthalmitis in 5 eyes (9. 8%), pigmentositis in 5 eyes (9. 8%), familial exudative vitreoretinopathy in 3 eyes (5. 9%), macular membrane and macular hole in 2 eyes (3. 9%). There were 3. 9 eyes with anterior segment surgery (2 eyes with lens aspiration, 1 eye with retinal cleavage, 2 eyes with retinal vein perivenous inflammation, 2 eyes with Marfan's syndrome) and 2 eyes with Marfan syndrome (2 eyes) with anterior segment surgery (2 eyes), 1 eye with retinal fissure (2 eyes), 2 eyes with retinal vein perivenous inflammation (Eals' disease)1) and 2 eyes with Marfan syndrome. 3) until the end of the follow-up, The rate of retinal anatomical reattachment was 86.3%, and there were still 7 cases (13.7%). The intraocular silicone oil was not removed (I. E. Silicone oil eye; in 28 cases, it was 54.9). The postoperative visual acuity of the affected eyes was better than that of the preoperative improvement (P 0.003) in 38 cases (74.5%). The corrected visual acuity of the affected eyes was better than that of the postoperative visual acuity (P 0.008), and the complications occurred in 20 cases (39.2%). Among them, complicated cataract was the first. 4) the main factors affecting the anatomical reattachment of retina and the recovery of visual function after vitrectomy were proliferative vitreoretinopathy, lens state, age at first visit, and simple rhegmatogenous retinal detachment. Conclusion. 1. Most of the patients with non-traumatic retinal detachment were male, with a high incidence age of 16-18 years. Myopia was the main cause. 2.Transplanated vitrectomy has a high success rate in the treatment of juvenile non-traumatic retinal detachment. However, due to the particularity of the children, the overall effect of the operation still needs to be further improved. Treatment methods and the use of silicone oil during operation also need further study. 3. The main factors affecting the anatomical reattachment of retina and the recovery of visual acuity after vitrectomy were proliferative vitreoretinopathy, lens state, age at first visit, and pure rhegmatogenous retinal detachment (P0.05).
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R779.6

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