眼球破裂伤早期玻璃体手术应用曲安奈德的临床分析

Clinical study the effects of early vitrectomy combined with triameinolone acetonide injection in vitreous cavity on rupture of the eyeballs

目的探讨眼球破裂伤早期玻璃体手术联合应用曲安奈德的疗效。方法眼球破裂伤一期手术修补眼球后早期行玻璃体手术时分为用药组（37例，37只眼）和对照组（39例，39只眼）。两组眼球破裂伤患者均一期手术修补眼球，术后7—14d行玻璃体手术。用药组术中向玻璃体腔注射曲安奈德，实施了可视化的玻璃体手术。结果眼球破裂伤早期玻璃体手术中玻璃体腔注射曲安奈德使得术中更能清楚的辨认玻璃体后皮质，视网膜前的增殖膜，内界膜等眼内组织。更好得完成人工的玻璃体后脱离，彻底清除玻璃体后皮质，减少了黄斑前玻璃体皮质残留所引起的并发症，术后炎症反应明显减轻。结论曲安奈德可以使得玻璃体可视化，提高了眼球破裂伤二次玻璃体手术的准确性与安全性，减少了术后的并发症，减轻了手术后的炎症反应。

Objective To explore the effects of early vitrectomy combined with triameinolone acetonide （TA） injection in vitreous cavity on rupture of the eyeballs. Methods The patients with rupture of the eyeballs after eye patch were divided into two groups, the medication group （37 cases, 37 eyes） and control group （39 cases, 39 eyes）. Two group of ocular rupture sick and wounded received homogeneous time surgery patches the eyeball, they were operated with vitrectomy after 7-14days. Triameinolone acetonide made pellu- cid vitrectomy visible were injected into the medication group during the vitrectomy. Results In vitrectomy, intmoperative staining with TA consistently improved direct visualization and delineation of the posterior hyaloids, ERM or ILM, facilitated their removed. The method can perfectly accomplish the artificial posterior detachment of vitreous, completely eliminate perimeter vitreous, and reduce the complication aroused by re- maining vitreous before macula, at the same time the method can evidently reduce postoperative inflammatory reaction. Conclusions TA can make pellucid vitreetomy visible, rising the reliability of vitrectomy, reduce operative complication, and relieve postoperative inflammatory reaction.