暴发性脉络膜上腔出血治疗分析

Clinical analysis of the treatment of fulminant choroidal hemorrhage

目的探讨暴发性脉络膜上腔出血的原因、临床表现、预防及治疗。方法对8例8只眼暴发性脉络膜上腔出血进行术中应急处理，术后对症保守治疗或手术治疗。结果随访一年6例白内障治疗后视力恢复到0．4- 0．8（矫正），眼压正常；1例新生血管性青光眼再次睫状体电透热术后，眼压恢复正常；早期病例的1例白内障患者行角巩缘大切口白内障囊外摘除术，发生暴发性脉络膜上腔出血后，给予各种对症治疗，眼压仍高，一年后眼球萎缩。结论该病的发生都有局部和全身的原因，内眼术中控制好眼内压波动是有效地预防方法，术中及时有效地关闭创口最重要，术后对症保守治疗亦可获得较好效果。

Objective To investigate the reasons of fulminant choroidal hemorrhage, clinical man- ifestations, prevention and treatment. Methods Eight eyes （8 cases） of fulminant choroidal hemor- rhage received surgery in emergency treatment, postoperative symptomatic conservative treatment, and surgical treatment, given a one-year follow-up. Results Six cases （6 cataract eyes） had the visual acuity to 0.4 to 0.8 （correction） after treatment, and intraocular pressure was normal; one patient （1 eye） with neovascular glaucoma carried out once again the ciliary body electric diathermy surgery, the intraocular pressure returned to normal. One case with early cataract carried out the corneo- scleral limbus large incision of extracapsular cataract extraction, occurred fulminant choroidal hemor- rhage was given the variety of symptomatic treatment, the intraocular pressure was still high, and one year later the eyeball was atrophy. Conclusions The occurrence of this disease has local and systemic causes, good control of intraocular pressure fluctuations in intraocular surgery is a good way to prevent, operation in a timely and effective closure the incision is the most important, postop- erative conservative treatment is the same desired effect or better results than surgery; also pay atten- tion to the medical malpractice.