气液交换在硅油取出术中应用的效果

Efficacy of application of air-fluid exchange during silicone oil removal

目的评估气液交换在硅油取出术中应用的效果。方法回顾性分析驻马店市第一人民医院2018年3月至2019年12月行硅油取出术的67例(67眼)的临床资料。患者分为两组:A组33例(33眼),接受单纯的硅油取出术;B组34例(34眼),接受硅油取出术,并行两次气液交换。术后随访3个月。结果术后1个月,B组高眼压发生率低于A组(χ^2=5.584,P=0.018)。术后3个月,A组高眼压者10例(30.30%),B组高眼压者2例(5.88%),两组比较差异有统计学意义(χ^2=6.793,P=0.009)。B组有1例(2.94%)玻璃体腔内硅油残留少于A组的8例(24.24%),χ^2=4.831,P=0.028。术后3个月,两组白内障、复发性视网膜脱离发生率差异均无统计学意义(χ^2=0.129,0.000;P=0.720,1.000)。两组均未发生脉络膜脱离、玻璃体积血等其他并发症。结论硅油取出术联合气液交换可减少玻璃体腔内硅油滴残留及高眼压的发生率,且手术并发症并无明显增加。

Objective To evaluate the efficacy of application of air-fluid exchange during silicone oil removal.Methods The clinical data of 67 eyes of 67 patients who underwent silicone oil removal from Mar.2018 to Dec.2019 in Zhumadian Municipal First People’s Hospital were retrospectively analyzed.They were divided into two groups.Group A,33 eyes of 33 patients,received silicone oil removal only,and group B,34 eyes of 34 patients,received silicone oil removal and two air-fluid exchanges.All patients were followed up for 3 months.Results At 1 month after surgery,the incidence of high intraocular pressure in group B was lower than that in the group A(χ^2=5.584,P=0.018).At 3 months after surgery,there was 10 cases with ocular hypertension in group A(30.30%),and 2 cases(5.88%)in group B.The difference was statistically significant(χ^2=6.793,P=0.009).The incidence of residual silicone oil in vitreous cavity in group B(2.94%)was less than that in group A(24.24%),the difference was statistically significant(χ^2=4.831,P=0.028).The differences in the incidence of cataract and recurrent retinal detachment were not statistically significant between the two groups at 3 months after operation(χ^2=0.129,0.000;P=0.720,1.000).There were no other complication such as choroidal detachment or vitreous hemorrhage in both groups.Conclusion Silicone oil removal combined with air-fluid exchange reduces the incidence of residual silicone oil droplets in vitreous cavity and ocular hypertension,and the operative complications are not significantly increased.