随访提醒对硅油填充视网膜脱落患者预后的影响

Effect of follow-up reminder on the prognosis of patients treated by retinal detachment filled with silicone oil

目的探讨术后电话随访对减少硅油填充相关并发症的影响。方法以2019年4月~12月于我院行玻璃体切除术联合硅油填塞治疗的90例复杂视网膜脱落患者作为研究对象,采用数列法以单双号将患者随机分为随访组和对照组,每组各45例。对照组患者于术后医嘱定期随访,观察组在医嘱随访的基础上,采用随访提醒模式,即建立电子随访档案,按月分类记录患者随访时间,于随访日前3日电话提醒患者。记录两组患者术后的随访损失率,硅油填塞的持续时间以及角膜病变情况,并对结果进行比较分析。结果对照组45例患者中有13例患者在术后6个月内未按医嘱门诊随访,随访流失率为28.89%,其中有10例患者在术后6个月后随访,3例患者永久流失。观察组45例患者中仅有6例在术后6个月内未按医嘱门诊随访,随访流失率为13.33%,其中4例于术后6个月后门诊随访,2例永久流失。组间比较,观察组门诊随访流失率相比对照组降低,差异具有统计学意义(χ^(2)=5.874,P=0.015)。观察组硅油填塞持续时间较对照组缩短,并且去除硅油前观察组患者眼压相比对照组降低,差异均具有统计学意义(P<0.05)。术后两组患者术后随访视力均较术后1d视力明显提高,观察组、对照组视网膜解剖复位率分别为97.67%、95.24%,差异无统计学意义(P>0.05);在术后并发症方面,观察组共发生2例,均为高眼压,发生率为4.65%,对照组共发生并发症12例,其中高眼压6例,角膜病变2例,硅油乳化4例,发生率为28.57%。组间比较,观察组患者硅油乳化以及并发症的总发生率均低于对照组,差异具有统计学意义(P<0.05)。结论定期随访是避免视网膜脱落经硅油填塞后并发症发生的重要环节,通过登记患者随访时间并给予电话提醒有助于提高患者随访的依从性,从而降低并发症的发生率。

Objective To investigate the effect of postoperative telephone follow-up on reducing silicone oil fill-related complications.Methods To select a total of 90 patients with complicated retinal detachment who underwent vitrectomy combined with silicone oil tamper in our hospital from April to December 2019 as the study subjects.The patients were randomly divided into the follow-up group and the control group by the sequence method with Numbers,45 cases were in each group.Patients in the control group were followed up regularly on the basis of postoperative doctor's orders,while patients in the observation group were followed up with follow-up reminder mode,electronic follow-up files were established to record patients' follow-up time according to monthly classification,and patients were reminded by telephone before the follow-up 3 days in advance.Then recorded the loss rate,duration of silicone oil tamponade and keratopathy of patients in the two groups,and compared and analyzed the results.Results Among the 45 patients in the control group,13 patients were not followed up according to the doctor's advice within 6 months after the operation,with a loss rate of 28.89%.Among them,10 patients were followed up 6 months after the operation,and 3 patients had permanent loss.In the observation group,only 6 of the 45 patients were not followed up in the outpatient department as prescribed by the doctor within 6 months after the operation,with a loss rate of 13.33%.Among them,4 patients were followed up in the outpatient department 6 months after the operation,and 2 patients had permanent loss.Compared with the control group,the outpatient follow-up attrition rate in the observation group was lower,with a statistically significant difference(χ^(2)=5.874,P=0.015).The duration of silicone oil packing in the observation group was shorter than that in the control group,and the intraocular pressure in the observation group was lower than that in the control group before silicone oil was removed,with statistically significant differences(P<0.05).Postoperative follow-up visual acuity of patients in both groups was significantly improved compared with that one day after surgery.The rate of retinal anatomical reduction in the observation group and the control group was 97.67% and 95.24%,respectively,with no significant difference(P>0.05).In terms of postoperative complications,a total of 2 cases occurred in the observation group with high intraocular pressure(4.65%),while 12 cases occurred in the control group,including 6 cases with high intraocular pressure,2 cases with keratopathy,and 4 cases with silicone oil emulsification(28.57%).The total incidence of silicone oil emulsification and complications in the observation group was lower than that in the control group(P<0.05).Conclusion Regular follow-up is an important step to avoid complications of retinal detachment after siliconization.It is helpful to improve patients' follow-up compliance by registering the follow-up time of patients and giving telephone reminders,thus reducing the incidence of complications.