药棉浸冷冷冻头冷凝视网膜裂孔临床实验研究

Clinical and experimental studies on seal retinal tears by cotton cryoprobe cooled liquid nitrogen

目的 评价药棉液氮浸冷冷冻头冷凝视网膜裂孔的安全性和疗效。方法 (1)动物实验分 2组 :I组药棉浸冷冻头直接接触兔巩膜 ,观察冷冻环和他的稳定性 ;II组处死家兔 ,取出眼球 ,巩膜开窗 ,通过窗口观察药棉冷冻头接触巩膜时 ,视网膜冷冻反应。 (2 ) 6 4例 6 4眼分成 2组 :I组用药棉冷冻头冷凝封孔 35例 ;II组用国产 CO2 冷冻仪封孔 2 9例。随访 3个月～ 4 a。结果 药棉冷冻头接触兔巩膜 2 s冷冻头四周出现冰环 ,与此同时 ,视网膜出现冷冻斑 ,冰环保持不变达 2 5 s,撤离冷冻头后 5 s,冰环及视网膜反应自然消失。 2组患者术后视力、视网膜复位率以及并发症 ,统计学分析分别为χ2 =4 .5 7、P >0 .0 5 ,χ2 =1.76、P>0 .0 5 ,χ2 =3.0 7、P >0 .0 5 ,I组和 II组相比差异无显著性。

Objective To evaluate cryotherapy safety and effect of liquid nitrogen cooled cotton cryoprobe on seal retinal tears.Methods The animals were divided into two groups, the first group, rabbit scleras were contacted by cotton cryoprobe which had been soaked in liquid nitrogen, scleral ice ring and its stableness was observed; The other, rabbits were killed by air injection , enucleation of eye was done and scleral windows were opened, looking into the window, retinal reaction was found while rabbit sclera was pressed by cotton cryoprobe. In Clinic, 64 eyes of 64 cases with rhegmatogenous retinal detachment were divided into two groups,the first group in 35 eyes of 64 cases ,retinal tears were frozen by cotton cryoprobe;The second group in 29 eyes of 64 cases were frozen by carbon dioxide cryoprobe made in China. Follow up period was from 3 months to 4 years. Results Ice ring around cryoprobe and freezing reaction on retina was observed in two seconds after rabbit scleras were indented. They lasted for 25 seconds before liquid nitrogen evaporated completely and disappeared automatically in five seconds after cotton cryoprobe was taken away. Postoperationally, there were no statistically significant difference of visual acuity?attachment ratio?complication between 35 eyes of 64 cases and 29 eyes of 64 cases (χ 2=4.57? P >0 05, χ 2=1 76? P >0.05, χ 2=3.07? P >0 05).Conclusion Freezing of cotton cryoprobe on seal retinal tears is effective and safe.