硅油填充眼视网膜前增殖膜统计学分析

Statistics analysis of epiretinal membrane after removing silicone oil

目的总结一定时期硅油取出术中剥除视网膜前膜的病例数，分析不同年龄、各类原始疾病、不同硅油填充时间视网膜前膜的发生率。方法临床病例回顾性分析研究。按纳入排除标准选择2009年1月至2011年2月在北京大学第三医院眼科中心入院诊断为硅油填充眼患者作为研究对象，总结硅油取出术中视网膜前膜（或黄斑前膜）病例数，并将其按原始疾病、硅油填充时间、年龄、性别等归类，统计膜生长情况。结果符合标准者420只眼；原发疾病中视网膜脱离占36．2％，眼外伤24．0％，增殖性糖尿病性视网膜病变22．6％，湿性黄斑变性10．5％。剥膜者229只眼（54．5％），0-14岁剥膜率38．71％，15-40岁为56．36％，41-60岁62．58％，60岁以上者为45．69％，χ^2值：4．05，P=0．011，差异有统计学意义（P〈0.05）。视网膜脱离剥膜率为50．66％，增殖性糖尿病性视网膜病变75．79％，眼外伤为53．46％，湿性黄斑变性27．27％，）（χ^2值=9．14，P〈0．001，差异有统计学意义。≤3月剥膜率为53．6％，〉3月至≤6月为49．0％，6月以上者为64．5％，）（χ^2值=4．25，P=0．026，差异有统计学意义（P〈0.05）。结论硅油填充术后有较高的视网膜前膜生成率，膜的形成与原始疾病、硅油填充时间、患者年龄有一定关系；硅油取出术中应重视对视网膜前膜的观察和处理，提高手术成功率。

Objective To summarize the cases of peeling epiretinal membrane after removing sili- cone oil and to analyze the incidence of epiretinal membrane in different ages, initial diseases and different filling time. Methods The patients who diagnosed silicone oil tamponade by exclusion cri- terion in Peking university eye center between Jan 2009 and Feb 2011 were selected. The cases of epiretinal membrane in the course of removing silicone oil were summarized. The rate of them by initial diseases and filling time and ages was analyzed. Results The eyes according with criterion were 420. Retinal detachment in them was 36.2%, proliferative diabetic retinopathy and blood age-re- lated macula degeneration was 22.6% and 10.5% respectively. Peeling epiretinal membrane was per- formed on 229 eyes. The rates of peeling membrane were 38.71%, 56.36%, 62.58% and 45.69% in different ages respectively. The difference had statistics significance （P =0.011）. In different diseases the rates were 50.66%, 75.79% and 27.27% respectively. The difference also had statistics signifi- cance （P 〈 0.001）. In different time the rates of peeling membrane were 53.6%, 49.0% and 64.5% respectively, they also had statistics significance （P =0.026）. Conclusions The silicone oil tampon- ade has high incidence of epiretinal membrane. It is related with initial diseases, silicone oil filling times and ages. In the operation of the silicone oil removal the treatment of the epiretinal mem- brane should be considered to improve the success rate.