本文選題：暴發(fā)性脈絡(luò)膜上腔出血 + 內(nèi)眼手術(shù)��； 參考：《眼科新進展》2016年02期

【摘要】：目的分析與評價內(nèi)眼手術(shù)及術(shù)中術(shù)后暴發(fā)性脈絡(luò)膜上腔出血的原因、處理和預(yù)后。方法選取暴發(fā)性脈絡(luò)膜上腔出血患者11例,術(shù)前5例合并高度近視,4例合并高眼壓,2例有既往內(nèi)眼手術(shù)史,2例患者發(fā)生二次出血。出血后采取保守或于出血后10~16 d(平均12.1 d)手術(shù)治療。手術(shù)方法包括單純后鞏膜脈絡(luò)膜上腔積血穿刺放液術(shù),或聯(lián)合玻璃體切割及硅油填充術(shù)。結(jié)果 11例患者中有7例發(fā)生于術(shù)中,4例發(fā)生在術(shù)后1~3 d,約占同期我科內(nèi)眼手術(shù)的0.15%(11/7204)。11例患者中,2例保守治療,4例行單純后鞏膜脈絡(luò)膜上腔積血穿刺放液術(shù),1例行玻璃體切割及后鞏膜脈絡(luò)膜上腔積血穿刺放液術(shù),另外4例行玻璃體切割硅油填充及后鞏膜脈絡(luò)膜上腔積血穿刺放液術(shù)。平均隨訪8.2個月,術(shù)后7例患者視力改善,1例無變化,3例惡化。結(jié)論術(shù)前高眼壓、高度近視及既往內(nèi)眼手術(shù)史是暴發(fā)性脈絡(luò)膜上腔出血的高危因素。通過術(shù)中迅速關(guān)閉切口,術(shù)后采取保守治療,擇機行后鞏膜脈絡(luò)膜上腔積血穿刺放液術(shù),視網(wǎng)膜脫離時聯(lián)合玻璃體切割術(shù),可保留患者部分視力。
[Abstract]:Objective to analyze and evaluate the causes, treatment and prognosis of intraocular surgery and postoperative fulminant suprachoroidal hemorrhage.Methods 11 cases of fulminant suprachoroidal hemorrhage, 5 cases of high myopia and 4 cases of high intraocular pressure were selected. 2 cases had previous history of intraocular surgery and 2 cases had secondary hemorrhage.Surgical treatment was performed on 10 ~ 16 days (mean 12.1 days) after bleeding.Surgical procedures include simple posterior scleral and suprachoroidal hemorrhage puncture and drainage, or combined vitrectomy and silicone oil filling.Results of the 11 cases, 7 cases occurred at 1 and 3 days after operation, accounting for about 0.15% of the total of 11 / 7204 cases in the same period. 2 cases were conservatively treated and 4 cases were treated with simple posterior scleral and suprachoroidal cavity hematocentesis and drainage. 1 case was treated by puncture and drainage of posterior scleral and suprachoroidal cavity hematocele.Vitrectomy and posterior scleral suprachoroidal hemorrhage,Another 4 cases underwent vitrectomy with silicone oil filling and posterior scleral superior choroidal hemorrhage puncture and drainage.The average follow-up was 8.2 months. The visual acuity was improved in 1 case and deteriorated in 3 cases.Conclusion preoperative high intraocular pressure, high myopia and previous history of intraocular surgery are high risk factors for fulminant suprachoroidal hemorrhage.Through the quick closure of incision, the conservative treatment after operation, the choice of posterior scleral and suprachoroidal hemorrhage puncture and drainage, retinal detachment combined with vitrectomy, the partial visual acuity of the patients can be preserved.
【作者單位】： 西安交通大學(xué)第二附屬醫(yī)院眼科;
【基金】：陜西省科學(xué)技術(shù)發(fā)展研究項目資助(編號:2012K19-05-05)~~
【分類號】：R779.6

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