23G套管硅油取出联合部分气液交换术的临床应用

Clinical application of silicone oil removal through 23-gauge trocar-cannulas combined with partial gas-liquid exchange

目的评估23G套管硅油取出联合部分气液交换术的临床应用效果。方法选取2020年1月至2022年6月福建医科大学附属南平第一医院行硅油取出术的71例(71眼)硅油填充患者作为研究对象。按照随机抽签法将其分为观察组和对照组。观察组35例(35眼),经结膜23G套管硅油取出并行部分气液交换术。对照组36例(36眼),经结膜23G套管硅油单纯取出。术后随访3个月,比较两组患者眼压、高眼压发生率、硅油残留率及术中、术后并发症发生情况。结果术后1周,两组患者的眼压与术前比较,差异无统计学意义(P>0.05),两组高眼压发生率比较,差异无统计学意义(P>0.05);观察组玻璃体腔硅油残留率低于对照组,差异有统计学意义(P<0.05)。术后1、3个月,两组患者眼压高于术前,差异有统计学意义(P>0.05),观察组高眼压发生率低于对照组,差异有统计学意义(P<0.05),术后1、3个月,观察组眼压低于对照组,差异有统计学意义(P<0.05)。两组患者均未发生复发性视网膜脱离、玻璃体积血以及脉络膜脱离等并发症。结论23G套管硅油取出联合部分气液交换术能有效地取净玻璃体腔硅油,减少硅油残留及高眼压的发生率,且未增加手术并发症。

Objective To evaluate the clinical effect of silicone oil removal through 23-gauge trocar-cannulas combined with partial gas-liquid exchange.Methods From January 2020 to June 2022,71 patients(71 eyes)with silicone oil filling in Affiliated Nanping First Hospital of Fujian Medical University were selected as the research objects.They were divided into observation and control groups according to the random lottery method.In the observation group,35 patients(35 eyes)underwent silicone oil removal through 23-gauge trocar-cannulas combined with partial gas-liquid exchange.In the control group,36 patients(36 eyes)underwent silicone oil removal through 23-gauge trocar-cannulas only.During the 3 months follow-up period,the incidences of intraocular hypertension,silicone oil residual rates and other complications were compared between the two groups.Results At 1 week after surgery,the incidences of ocular hypertension were not statistically significant between the two groups(P>0.05).The residual rates of silicone oil in vitreous cavity in the observation group were lower than that in the control group(P<0.05).At 1,3 months after surgery,the incidences of ocular hypertension in observation group were lower than that in the control group(P<0.05).During the 3 months follow-up period,there were no complications such as recurrent retinal detachment,vitreous hemorrhage or choroidal detachment in both groups.Conclusion The silicone oil removal through 23-gauge trocar-cannulas combined with partial gas-liquid exchange could extract silicone oil from vitreous cavity effectively,reduce the incidences of residual silicone oil bubbles and ocular hypertension.Moreover,the operative complications were not significantly increased.