玻璃体切除治疗出血性玻璃体视网膜疾病

Vitrectomy for hemorrhagic vitreoretinal diseases.

目的探讨玻璃体切除术对出血性玻璃体视网膜疾病的临床效果。方法对39例（40眼）玻璃体积血施行三通道经睫状体平坦部玻璃体切除术，联合膜剥离，水下透热，眼内光凝（或经巩膜冷凝），并根据病情选用眼内长效填充材料。结果视网膜静脉阻塞15眼，外伤性玻璃体积血9眼，视网膜孔源性玻璃体积血6眼，珠网膜下腔出血合并玻璃体积血（Terson综合症）4眼，静脉周围炎（Eales病）5眼，老年性黄斑变性1眼。术后随访2～40月，平均（12±3．4）月，40跟视力均有不同程度的提高，0．05以上者33眼（82．50％），与术前相比差异有统计学意义（P〈0．05），视力0．2～0．8者26跟占65．00％。结论出血性玻璃体视网膜疾病经药物治疗无效，B超探示出现玻璃体后脱离或B超显示伴有牵引性视网膜脱离者，玻璃体切除术是消除玻璃体积血并使视网膜复位的有效方法。

Objective To study the clinical curative effects of vitrectomy for vitreoretinal bleeding diseases. Methods A total of 39 cases （40 eyes） of vitreous hemorrhage underwent vitrectomy combined with membrane peeling,diathermy, retinal photocoagulation and the application of long effective materials according to particular situation respectively. Results Conditions of the eyes included retinal vein occlusion in 15 eyes ,traumatic vitreous hemorrhage in 9 eyes,rhegmatogenous vitreous hemorrhage in 6 eyes, subarachnoid hemorrhage combined with vitreous hemorrhage in 4 eyes,retinal periphlebitis in 5 eyes and senile macular degeneration in 1 eye. Postoperative follow-up was 2-40 months with median （ 12 ± 3.4） months. All of the visual acuity was improved to a certain extent. 33 eyes was above 0. 05 （ 82.5% ）, there was significant difference between preoperative and postoperative vision （P 〈 0. 05）. Conclusion Vitreetomy is an effective method to hemorrhagic vitreoretinal diseases.