改良23G玻璃体切除系统行硅油取出术的研究

Clinical research of silicone oil removal through modified 23-gauge vitrectomy system

【摘要】目的评价以一次性输血器自制管道连接于23G玻璃体切除系统进行硅油取出术的有效性和安全性。方法回顾性分析2015年12月至2016年3月在甘肃省人民医院住院行玻璃体腔硅油取出手术20例（20只眼）。将一次性输血器的两端剪除，保留软管，一端连接玻璃体切除器的积液盒，另一端直接套于23G穿刺套管外面，利用玻璃体切除器的负压吸引系统通过睫状体平坦部的切口，主动抽吸取出玻璃体腔内硅油。记录平均手术时间、取油时间及眼压，观察术中术后并发症。结果20例均顺利取出硅油，手术时间平均为（16．95±5．02）min，其中取油时间平均为（5．45±1．57）min。术前平均眼压为（17．85±6．19）mmHg（1mmHg=0．133kPa），术后1d、3d、1周及1个月的平均眼压分别为（13．05±3．98）mmHg、（13．40±4．01）mmHg、（14．55±3．86）mmHg、（17．20±3．94）mmHg。术中及术后均未见明显的并发症。结论以一次性输血器自制管道连接于23G玻璃体切除系统进行硅油取出是一种安全、有效、快捷的方法。

Objective To evaluate the efficacy and safety of silicone oil removal with 23-gauge vitrectomy system linked self-made suction pipeline made by disposable transfusion tube. Methods Twenty eyes of 20 patients who underwent removal of Oxane 5700 silicon oil were collected. The data were retrospectively analysed. The suction pipeline was made with a disposable transfusion tube, in which the two ends were cut. One end was connected with the effusion box of the vitrectomy unit, the other end was connected with 23-gauge puncture cannula. The intraocular silicone oil was proactively sucted and removed through incision on pars plana with the vitrectomy unit suction system. The mean operation time, silicone oil removal time, the intraocular pressure（IOP） and complications between preoperative and postoperative were recorded. Results The silicone oil was removed successfully in all patients. The mean operation time was （16.95 _＋ 5.02） min and silicone oil removal time was （5.45 ± 1.57 ） rain. Mean preoperative IOP was （17.85 ± 6.19） mmHg（ 1 mmHg = 0. 133 kPa）. Mean IOP at postoperative 1 day, 3 days, 1 week and 1 month were （ 13.05 ± 3.98） mmHg , （ 13.40 ± 4.01 ） mmHg, （ 14.55 ± 3.86） mmHg and （ 17.20 ± 3.94） mmHg, respectively. There was no intraoperative or postoperative complication. Conclusion This technique for removal of silicone oil through 23-gauge vitrectomy system linked self-made suction pipeline mode by disposable transfusion tube is safe, effective, fast and economic.