玻璃体切割硅油填充术后头低位时间与术后情况关系的研究

Evalution the Patients Situation between Difference Time of Crouching Positioning after Vitrectomy with Silicone Oil Tamponade

目的 探讨合理的头低或俯卧位时间 ,在保证视网膜复位的情况下尽量减轻患者不适表现 ,以利于早日康复。方法 采用便利取样法选取 2 0 0 2年 3～ 5月在协和医院眼科住院治疗的视网膜脱离需行玻璃体切割加硅油填充的患者。行玻璃体切割加硅油填充术后实验组每日头低位 8h ;对照组每日头低位 14h。利用裂隙灯 ,间接眼底镜 ,分别观察 2组患者在术后第 3d、第 7d、第 14d的视网膜复位情况、眼睑水肿情况、肌肉酸痛、食欲及自理能力情况。结果 玻璃体切割加硅油填充术后 2组患者视网膜复位率无显著性差异 (P >0 .0 5 )。眼睑水肿发生率、肌肉酸痛发生率、食欲减退情况、生活自理情况在术后第 3d、第 7d 2组有显著性差异 (P<0 .0 5 ) ,第 14d则均无显著性差异 (P >0 .0 5 )。结论 减少头低位的时间对视网膜的复位效果无不良影响 ,但可有效的降低由于头低位所带来的一系列伴随症状的发生率和程度 ,提高患者的生活自理能力 ,增进食欲 ,缓解肌肉酸痛增加舒适感 ,为患者术后的恢复提供了良好的身体条件。

Objective To investigate the reasonable period of keeping crouching or prostrate position, in order to alleviate discomfort in patients and ensure retinal restoration.Methods To sample the patients suffering from retinal detachment, underwent vitrectomy and silicone oil tamponade in Peking Union Medical College Hospital from March to May in 2002. The patients kept crouching 8 hours every day postoperatively in experimental group, and 14 hours in control. To examine retinal restoration and lid edema by slit lamp and indirect funduscope, as well as muscle aching, appetite and independence postoperatively.Results There is no significant difference on retinal restoration ratio between the experimental group and the control. However, there are significant differences on lid edema, muscle aching, appetite and independence postoperatively on the 3rd and 7th day, in addition to no difference on the 14th day.Conclusions It could do no disadvantage effect on retinal restoration to decrease crouching period. However, it might effectively alleviate discomfort accompanying with crouching position, and accelerate recovery postoperatively.