两步法巩膜穿刺在微创玻璃体切割手术中的应用

发布时间：2018-01-01 12:12

本文关键词：两步法巩膜穿刺在微创玻璃体切割手术中的应用　出处：《眼科新进展》2015年01期 　论文类型：期刊论文

【摘要】：目的探讨两步法巩膜穿刺在微创玻璃体切割手术中的应用。方法回顾性分析2009年10月至2011年4月在我院行微创玻璃体切割手术的患者586例(586眼),手术全部应用23 G玻璃体切割系统,按其所接受的巩膜穿刺方式分为A组(一步法巩膜穿刺组)和B组(两步法巩膜穿刺组)。A组即应用23 G套管穿刺刀做巩膜穿刺,其他操作同常规手术。两步法巩膜穿刺在用23 G套管穿刺刀之前,预先用0.6 mm巩膜穿刺刀做巩膜穿刺,然后用23 G套管穿刺刀从预穿口进入,其他操作同常规手术。对比两种术式的手术效果。结果 A组平均每套套管穿刺刀使用3次,B组平均每套套管穿刺刀使用95次,B组平均每套使用次数是A组的31.7倍。A组术前、术后3个月视力和B组术前、术后3个月视力比较,差异均无统计学意义(均为P0.05),两组术后3个月视力与手术前比较,差异均有统计学意义(均为P0.01)。A组术后1 d和1周眼压分别为(12.69±5.84)mmH g(1 kP a=7.5 mmH g)和(14.30±4.03)mmH g,B组术后1 d和1周眼压分别为(13.13±5.28)mmH g和(14.80±3.44)mmH g,两组比较差异均无统计学意义(均为P0.05),两组术后1 d和1周眼压与术前比较,差异均有统计学意义(均为P0.05)。结论两步法巩膜穿刺微创玻璃体切割手术最大限度地降低了23 G套管穿刺刀穿刺的难度,增加了23G套管穿刺刀重复使用次数,节约了手术成本,减轻了患者的经济负担,为23 G微创玻璃体切割手术的广泛开展提供了更大优势。
[Abstract]:Objective to investigate the application of two-step scleral puncture in minimally invasive vitrectomy. Methods 586 cases of minimally invasive vitrectomy from October 2009 to April 2011 in our hospital were retrospectively analyzed. 586 eyes. All the operations were performed with 23G vitrectomy system. According to the method of scleral puncture, they were divided into A group (one step scleral puncture group) and B group (two-step scleral puncture group). Other procedures were the same as routine operation. Two step scleral puncture was performed with 0.6 mm scleral puncture knife before using 23G cannula puncture knife, and then 23 G cannula puncture knife was used to enter the preset hole. Other operations were compared with the conventional operation. Results the average value of each set of cannula puncture knife in group A was 3 times and that in group B was 95 times per set of cannula puncture knife. The average usage times of each set in group B were 31.7 times as much as those in group A. There was no significant difference in visual acuity between group A and group B 3 months after operation and 3 months after operation (all P 0.05). Visual acuity was compared between the two groups 3 months after operation. The intraocular pressure of group A was 12.69 卤5.84 卤5.84 卤5.84 mmH / g, respectively, and the intraocular pressure of group A was 7.5 mmH / g at 1 day and 1 week after operation, respectively. And 14.30 卤4.03 mm Hg. In group B, intraocular pressure was 13.13 卤5.28mm / g and 14.80 卤3.44mm / g respectively on day 1 and week 1 after operation. There was no significant difference between the two groups (P 0.05). The intraocular pressure was compared 1 day and 1 week after operation between the two groups. The difference was statistically significant (P 0.05). Conclusion Two-step scleral puncture minimally invasive vitrectomy can minimize the difficulty of 23 G cannula puncture. The repeated use of 23G cannula puncture knife was increased, the cost of operation was saved, the economic burden of patients was reduced, and the more advantages were provided for the extensive development of 23G minimally invasive vitrectomy.
【作者单位】：济南市明水眼科医院;
【分类号】：R779.6
【正文快照】： 玻璃体切割手术应用于临床以来,显著改善了25 G、23 G玻璃体切割系统的巨大变迁。近年来,25玻璃体视网膜疾病的预后[1],先后经历了20 G、G、23 G微创玻璃体手术系统由于巩膜切口和手术器械直径较小、创伤小、恢复快而应用逐渐增多。231.2.2手术方法所有手术操作均由同一术者

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