二种负压吸引方式硅油取出术临床观察

Clinical observation of silicone oil removal via two negative pressure methods

目的观察二种负压吸引方式硅油取出术的手术效果。方法回顾性分析2013年3月至2015年2月以及2015年3月至2016年8月两个阶段在本院行硅油取出术的临床连续病例。采用二种负压方式:前一阶段是采用负压吸引器恒定负压硅油取出28例(28只眼)。后一阶段是采用20 ml一次性注射器抽吸10 ml后固定住活塞,利用此产生的递减负压取出硅油29例(29只眼)。结果前组病例中有硅油泡残留8只眼,脉络膜脱离2只眼,视网膜再脱离2只眼,后组无明显硅油泡残留,有1只眼视网膜再脱离,术中、术后无脉络膜上腔出血、脉络膜脱离等并发症发生。结论一次性注射器抽吸所产生的递减负压较负压吸引器产生的恒定负压更有利于眼内硅油的安全有效取出,硅油残留少。

Objective To observe the results of silicone oil removal surgery via two negative pressure methods. Methods Consecutive cases of two phases （ Mar 2013 to Feb 2015 and Mar 2015 to Aug 2016 ） of silicone oil removal sur- gery were analyzed retrospectively..9 Two negative pressure methods were adopted. In the first phase, silicone oil removal surgery carried out with constant negative pressure produced by negative pressure aspirator on 28 eyes. In the second phase, disposable syringes （ 20 ml） were used to remove silicone oil from 29 eyes by the decreasing negative pressure. Re- sults There were residual silicone oil bubble in 8 eyes treated the first phase and 2 patients experienced choroidal detach- ment, 2 patients experienced retinal re-detachment after operation. In contrast, there was no residual silicone oil bubble found in any patient treated in the second phase. One patient experienced retinal re-detachment after operation. There were no complications such as repulsive choroidal hemorrhage during an operation or after surgery. Conclusions Decreasing negative pressure produced by disposable syringe was more safe and effective than constant negative pressure produced by negative pressure aspirator for silicone oil removal.