外伤性前房积血手术中前房注入消毒空气泡与C_3F_8气体的应用比较

Comparison of anterior chamber injection of sterile air bubbles and C_3F_8 in surgery of traumatic hyphema

目的观察消毒空气泡和C3F8气体在严重外伤性前房积血行前房冲洗术中的应用效果。方法 50例(50眼)严重外伤性前房积血患者前房冲洗后,A组前房注入消毒空气泡,B组前房注入体积分数12%C3F8气体。分别比较A、B两组术前与术后1 d、3 d、7 d、1个月的最佳矫正视力(best corrected visual acuity,BCVA)、眼压和前房等情况。结果 A、B组术后1 d、3d、7 d、1个月BCVA与术前比较,差异均有统计学意义(均为P<0.05);术前及术后1个月A、B两组间BCVA比较,差异均无统计学意义(χ2=0.35、3.28,均为P>0.05);术后1 d、3 d、7 d A、B两组间BCVA比较,差异均有统计学意义(χ2=13.75、38.46、46.86,均为P<0.05)。A组及B组术后1 d眼压与术前比较,差异有统计学意义(P<0.05);术后3 d、7 d、1个月眼压与术前比较,差异均无统计学意义(均为P>0.05);术前及术后1 d、3 d、7 d、1个月两组眼压比较,差异均无统计学意义(均为P>0.05)。结论消毒空气泡和C3F8气体在严重外伤性前房积血手术中均能有效地控制活动性出血,使视力提高、眼压正常,但前房注入消毒空气泡更方便、经济、并发症少。

Objective To compare the effects of sterile air bubbles and C3F8 gas in anterior chamber irrigation surgery for traumatic hyphema. Methods Fifty cases （50 eyes） with traumatic hyphema were divided into two groups. Group A were injected sterile air bubbles and group B 20 cases injected 12% C3F8 gas. The changes of intraocular pressure（ IOP）, visual acuity and complication preoperatively and 1 day,3 days, 7 days and 1 month postoperatively were observed. Results There were significant differences between preoperative and postoperative visual acuity at 1 day,3 days,7 days and 1 month in group A and B（ all P 〈0.05 ）. There were significant differences in preoperation and postoperative visual acuity at 1 day, 3 days and 7 days between group A and B（x^2 = 13.75,38.46,46.86, all P 〈 0.05 ）, but no statistical difference was found at pre-operation and postoperative 1 month between two groups （x^2 = 0.35,3.28, all P 〉 0. 05）. There were significant differences between pre-operation zaad postoperative IOP at 1 day in group A and B（P 〈0.05 ,no significant difference between pre-operation and postoperative IOP at 3 days,7 days and 1 month（ all P 〉 0.05 ）, and no statistical difference in pre-operation and postoperative IOP at 1 day,3 days,7 days and 1 month between two groups （ all P 〉 0.05 ）. Conclusion Both sterile air bubbles and C3 F8 gas can prevent the active hyphema, effectively improve visual acuity and reduce IOP in anterior chamber irrigation surgery for traumatic hyphema, but sterile air bubbles is cheaper with less postoperative complications.