内眼手术中出现脉络膜上腔出血的临床分析

Clinical view of suprachoroidal hemorrhage during intraocular surgery

目的探讨内眼手术中脉络膜上腔出血患者的危险因素及处理。方法对我院2010年1月至2016年3月收治的8例(8只眼)内眼手术中脉络膜上腔出血患者临床资料进行回顾性分析,其中男性5例(5只眼),女性3例(3只眼),年龄31~76岁(平均58.2岁)。随访1~36个月,平均随访时间9.8个月。结果术前高眼压、高度近视、玻璃体切除术后眼及既往高血压病史患者易发生脉络膜上腔出血。8例患者除1例放弃治疗后眼球萎缩,其余7例(7只眼)经过保守治疗后不仅保住眼球,而且有一定的视力。结论术中维持稳定的眼压可降低内眼手术中脉络膜上腔出血的发生,重视患者入院时的全身疾病及眼部情况,术中及时发现并行有效的急救处理,术后给予患者正确的身心护理,有利于患者的康复,减少医患纠纷。

Objective To study the risk factors and treatment options for suprachoroidal hemorrhage during intraocular surgery. Methods We retrospectively analyzed records of 8 cases（ n=8 eyes） of suprachoroidal hemorrhage during intraocular surgery from January 2010 to March 2016. The patients＇ ages ranged from 31 to 76 years old（ mean 58.2 years）. Patients were followed up for 1-36 months and the average follow-up time was 9.8 months. Results Preoperative high intraocular pressure,high myopia,vitrectomy,and the history of hypertension are the main risks of suprachoroidal hemorrhage. After conservative treatment,7 eyes had certain visual acuity restored. Conclusions The stability of intraocular pressure can decrease the incidence of suprachoroidal hemorrhage during intraocular surgery. Pay attention to systemic diseases and eye condition in patients. Effective treatment during the surgery and appropriate physical and psychological care after the surgery are keys to rehabilitation.