【摘要】：【目的】分析20G與23G玻璃體切割手術(shù)治療后段眼內(nèi)異物的臨床療效,探討兩者有效性及安全性差異�！痉椒ā炕仡櫺圆±芯�。選取接受不同玻璃體切割手術(shù)治療的后段眼內(nèi)異物71例71只眼,根據(jù)術(shù)式不同分為20G玻璃體切割手術(shù)組(20G組)及23G玻璃體切割手術(shù)組(23G組),前者37例37只眼,后者34例34只眼。對(duì)象均予創(chuàng)口縫合,合并外傷性白內(nèi)障者聯(lián)合白內(nèi)障手術(shù),行20G/23G玻璃體切割聯(lián)合球內(nèi)異物取出,術(shù)中酌情行視網(wǎng)膜激光光凝、冷凝及眼內(nèi)填充治療。記錄異物取出及視網(wǎng)膜復(fù)位情況、手術(shù)時(shí)間、術(shù)后炎癥反應(yīng)及眼部刺激癥狀、住院時(shí)間、最佳矯正視力以及術(shù)后并發(fā)癥等情況,隨訪至少6個(gè)月�！窘Y(jié)果】?jī)山M眼內(nèi)異物取出率及初期視網(wǎng)膜復(fù)位率均100%;除術(shù)后低眼壓發(fā)生率兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)外,其余并發(fā)癥比較差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組的手術(shù)時(shí)間、平均住院日、術(shù)后炎癥反應(yīng)評(píng)分與眼部刺激癥狀以及兩組手術(shù)前后的視力分布進(jìn)行自身比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。至末次隨訪,兩組各自接受的非計(jì)劃再次手術(shù)例數(shù)、視網(wǎng)膜復(fù)位情況以及術(shù)后視力分布情況比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)�！窘Y(jié)論】20G與23G玻璃體切割手術(shù)治療后段眼內(nèi)異物均安全有效,兩者臨床療效及手術(shù)安全性相當(dāng);23G組術(shù)后低眼壓發(fā)生率更高,但在縮短手術(shù)時(shí)間及住院時(shí)間、減輕術(shù)后炎癥反應(yīng)及眼部刺激癥狀方面較20G組更有優(yōu)勢(shì)。
[Abstract]:[objective] to analyze the efficacy and safety of 20 G and 23 G vitrectomy for posterior intraocular foreign bodies. [methods] retrospective study. 71 cases (71 eyes) of posterior intraocular foreign bodies treated with different vitrectomy were divided into 20G vitrectomy group (20G group) and 23G vitrectomy group (23G group). There were 37 eyes in 37 cases and 34 eyes in 34 cases in the latter group. All patients were treated with wound suture, traumatic cataract combined with cataract surgery, 20G/23G vitrectomy and extraction of intraocular foreign bodies. Retinal laser photocoagulation, condensation and intraocular filling were performed as appropriate. Foreign body removal and retinal reattachment, operation time, postoperative inflammatory reaction and ocular irritation symptoms, hospital stay, best corrected visual acuity and postoperative complications were recorded. [results] the removal rate of intraocular foreign bodies and the initial retinal reattachment rate were 100 in both groups, except the incidence of low intraocular pressure in the two groups (P0.05), but there was no significant difference in other complications (P0.05). The operation time, average hospital stay, postoperative inflammatory response score, ocular irritation symptoms and visual acuity distribution before and after operation were compared between the two groups. The difference was statistically significant (P0.05). To the last follow-up, the number of unplanned reoperation cases, retinal reattachment and visual acuity distribution were compared between the two groups. [conclusion] both 20G and 23G vitrectomy are safe and effective in the treatment of posterior intraocular foreign bodies. The clinical efficacy and safety of the two groups are similar to those of the 23G group, and the incidence of low intraocular pressure is higher in the 23G group. But it has more advantages than 20G group in shortening operation time and hospitalization time, reducing postoperative inflammatory reaction and ocular irritation symptoms.
【作者單位】： 溫州醫(yī)科大學(xué)附屬臺(tái)州醫(yī)院眼科;溫州醫(yī)科大學(xué)附屬第二醫(yī)院眼科;
【分類號(hào)】：R779.6

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