前房穿刺放液在视网膜脱离外路手术中的临床应用研究

摘要

目的：探讨前房穿刺放液治疗视网膜脱离的临床效果，寻找最佳治疗方法。方法：选择符合标准的患者80例，随机分为观察组和对照组各40例，观察组采用前房穿刺放液，对照组引流视网膜下液，应用巩膜外垫压手术复位。结果：两组患者均术后随访6～12个月，对照组患者视网膜复位36眼，失败4眼，手术成功率为90．00％；观察组患者视网膜复位38眼，失败2只眼，手术成功率为95．00％，差异无统计学意义（ P＞0．05）。术后1周，观察组患者视力进步34眼（85．00％）、视力保持不变4眼（10．00％）和视力下降2眼（5．00％）；对照组患者视力进步25眼（62．50％）、视力保持不变8眼（20．00％）和视力下降7眼（17．50％），差异有统计学意义（P＜0．05）。观察组患者并发症发生率7．50％，低于对照组的20．00％，差异有统计学意义（ P＜0．05）。结论：手术治疗视网膜脱离，术中采用前房穿刺放液代替引流视网膜下液降低眼压，安全可靠、简便快捷、缩短手术时间、降低手术风险、提高临床疗效，值得临床推广应用。%Objective: To investigate the clinical efficacy of tapping anterior chamber in treatment of retinal detachment , and to search for the best therapy .Method:80 eligible patients were selected and ran-domly divided into observation group and control group , with 40 patients in each group;the observation used tapping of anterior chamber , while the control group used drainage of subretinal fluid , and scleral buckling surgery is used for surgical reduction .Result:The patients of both groups were followed up for 6~12 months. Reattachment of retina was successful in 36 eyes and failed in 4 eyes in the patients of the control group , and the achievement ratio was 90.00%; while reattachment of retina was successful in 38 eyes and failed in 2 eyes in the patients of the observation group , and the achievement ratio was 95.00%;and the difference was statistically insignificant (P>0.05).At 1 week after the surgery, the vision was improved in 34 eyes (85. 00%), was not changed in 4 eyes (10.00%), and was impaired in 2 eyes (5.00%) in the patients of the observation group;while the vision was improved in 25 eyes ( 62.50%) , was not changed in 8 eyes ( 20. 00%) , and was impaired in 7 eyes ( 17.50%) in the patients of the control group; and the difference was statistically significant (P<0.05).The incidence of complications in the patients of the observation group was 7.50%, while that in the patients of the control group was 20.00%, and the former was significantly lower ( P<0.05) .Conclusion:Tapping of anterior chamber , instead of drainage of subretinal fluid , in surgery for reti-nal detachment is safe , reliable , convenient , and quick , can shorten operative time , decrease operative risks, and elevate clinical efficacy , and consequently is worthy of clinical application .