摘要:
Objective To evaluate the efficacy and safety of intravitreal gas injection in treatment of macular hemorrhage with combination of Chinese traditional and Western medicine.Methods Selection of macular hemorrhage in 52 cases (60 eyes) underwent intravitreal gas injection treatment.Intraoperative anterior chamber puncture released 0.1ml aqueous humor,intravitreal injection of long-acting gas perfluoropropane (C3F8) 0.3ml,the intraocular pressure measurement was normal,light projection clear.Postoperative strictly kept the body position for more than 1 week.After gas injection to observe the changes of visual acuity,intraocular pressure and ocular fundus were observed.On the fifth days postoperative,the compound Xueshuantong intravenous infusion of 500rag was given.Results One day postoperative,hemorrhage position displaced away from the fovea centralis in 40 eyes (66.7%,40/60),vision improved in 45 eyes (75%,45/60).The corrected visual acuity improved from LP (Light Perception)-0.3 preoperative to CF (Counting Fingers)-0.6.One week postoperative,50 eyes (83.33%,50/60) of macular hemorrhage partly absorbed or visual acuity improved including in 41 eyes (68.33%,41/60),and the visual acuity improved ≥2 lines.Two weeks postoperative,55 eyes (91.67%,55/60) of macular hemorrhage was significantly absorbed or hemorrhage position displaced away from the fovea centralis.Corrected visual acuity improved to CF to 1.0,including in 46 eyes (76.67%,46/60) the visual acuity improved ≥2 lines.On 1 day,1 week and 2 weeks postoperative visual acuity was increased obviously,the difference was statistically significant (P <0.05).Conclusions Intravitreal gas injection therapy is a simple and effective method for the simple type of macular hemorrhage,macular hemorrhage,small area bleeding,early bleeding,especially for traumatic macular hemorrhage.The combined use of compound Xueshuantong can improve the efficacy,shorten the course of disease.It can be widely popularized in basic level hospital treatment.%目的 中西医结合玻璃体腔内注气治疗黄斑出血,评价其有效性及安全性.方法 对2007年1月至2014年4月在汕头大学第一附属医院眼科选取黄斑出血患者52例60只眼均行玻璃体腔内注气术治疗.术中前房穿刺放出0.1 ml房水,玻璃体腔内注入长效气体全氟丙烷(C3F8)0.3ml,指测眼压正常,光感明确.术后严格保持面向下体位1周以上.注气后观察视力变化、眼压和眼底等情况.术后5天开始予复方血栓通500 mg静滴.结果 术后第一天可见40只眼(66.7%,40/60)出血灶移位至黄斑中心小凹以外,45只眼(75%,45/60)视力均有不同程度提高.矫正视力由治疗前的光感~0.3提高至指数~0.6,术后1周50只眼(83.33%,50/60)黄斑区积血部分吸收或视力有所提高,其中视力提高≥2行41只眼(68.33%,41/60),术后2周55只眼(91.67%,55/60)黄斑区积血明显吸收或移位至黄斑区以外,矫正视力提高至指数~1.00,其中视力提高≥2行46只眼(76.67%,46/60).术后第1天、术后第1周和术后第2周视力较术前均有明显提高,其差异有统计学意义(P<0.05).结论 玻璃体腔注气疗法是治疗黄斑出血的一种简单而有效的方法,对于单纯型黄斑出血、出血面积较小、早期出血者,尤其对外伤所致黄斑出血效果显著.联合使用复方血栓通,提高疗效,缩短病程.是能广泛在基层医院推广的治疗方式.