单纯玻璃体积血病因及手术治疗回顾性分析

Retrospective analysis on the causes and surgical treatment of simple vitreous hemorrhage

目的回顾性分析单纯玻璃体积血的病因及手术治疗时机和效果。方法对171眼单纯性玻璃体积血患者的临床资料进行回顾性分析。手术采用玻璃体切除术(PPV),术后随访时间6~24个月,结果数据采用SPSS10.0统计学软件进行统计学分析。结果 (1)病因:171眼玻璃体积血患者中,视网膜分支静脉阻塞116眼(67.83%),视网膜裂孔18眼(10.52%),老年黄斑变性18眼(10.52%),视网膜中央静脉阻塞10眼(5.84%),视网膜静脉周围炎7眼(4.09%)。(2)手术效果:术前最佳矫正视力>0.05者5眼(2.92%),术后最佳矫正视力>0.05者144眼(84.21%),术后最佳矫正视力较术前显著提高(P<0.01)。结论老年患者单纯玻璃体积血以视网膜分支静脉阻塞为最多见,其次为视网膜裂孔和老年黄斑变性。年轻患者以视网膜静脉周围炎为最多见。玻璃体切割术治疗单纯玻璃体积血疗效显著,可有效改善患者视功能,减少并发症,应尽早进行玻璃体切割手术。

Objective To analyse the cause and the time and effect of surgical treatment in simple vitreous hemorrhage retrospectively. Methods A retrospective analysis of 171 eyes with simple vitreous hemorrhage was performed. Vitrectomy（ PPV） was used in the operation. The data results were analyzed by SPSS10. 0. Results（1） Pathogeny： among the 171 eyes,116 eyes（ 67. 83%） were caused by branch retinal vein occlusion,18 eyes（ 10. 52%） were caused by retinal hole,18 eyes（ 10. 52%） were caused by age-related macular degeneration,10 eyes（ 5. 84%） were caused by central retinal vein occlusion,7 eyes（ 4. 09%） were caused by Eales disease.（2）Operation effect：The preoperative best corrected visual acuity（ BCVA） was better than 0. 05 in 5 eyes（ 2. 92%）,and the postoperative best corrected visual acuity（ BCVA） was better than 0. 05 in 144 eyes（ 84. 21 eyes）. The BCVA after operation was significantly higher than that before operation（ P〈0. 01）. Conclusion Among the aged patients,branch retinal vein occlusion is the principle cause of simple vitreous hemorrhage,and the retinal hole and age-related macular degeneration are the second. Eales disease is the principle cause of simple vitreous hemorrhage among the young patients. Vitrectomy is an effective method for simple vitreous hemorrhage,which can improve and protect patients＇ visual acuity.Vitrectomy should be carried out as soon as possible.