两种方法治疗玻璃体积血的临床观察

Clinical observation of two treatments for vitreous hemorrhage

摘要:

目的：探讨玻璃体积血的保守治疗及手术治疗两种方法的适应证及治疗效果。

方法：记录我院2008/2013年玻璃体积血患者的积血原因、病情程度、治疗手段、最终效果，并对不同治疗方法的疗效进行对比分析。

结果：选取22例24眼保守治疗的患者中有6眼(25%)视力程度不同的提高，5眼(21%)发生继发性视网膜脱离未行治疗，3眼(12.5%)出现新生血管性青光眼而行冷冻或减压阀植入，眼球状态稳定但视力完全消失，手术组26例31眼中视力提高17眼(55%)，第二次手术2眼(6.5%)，第3次手术2眼(6.5%)，眼球萎缩3眼(10%)。保守治疗的最终视力提高例数明显低于手术治疗的患者(P<0.05)。

结论：手术治疗仍是玻璃体积血治疗的积极手段，但会出现眼球萎缩等严重并发症，因此应根据不同的治疗对象及治疗时机选择不同的治疗方法。

Abstract:

AIM: To investigate the indications and therapeutic effect of the conservative treatment and surgical treatment for vitreous hemorrhage.

METHODS: Hemorrhage reasons, degree of illness, and treatment and final results of vitreous hemorrhage were recorded from 2008 to 2013, and curative effect of different treatments was analyzed.

RESULTS: Selected 22 cases(24 eyes)of conservative treatment, vision degree of 6 eyes(25%)had raised, 5 eyes(21%)occurred secondary retinal detachment without treatment, 3 eyes(12.5%)suffered neovascular glaucoma were underwent operation, but the vision had lost completely. In 26 cases(31 eyes)of control(operation)group, vision of 17 eyes(55%)had improved, 2 eyes(6.5%)suffered the second operation, 2 eyes(6.5%)suffered the third surgery, 3 eyes(10%)suffered eyeball atrophy. The number of ultimate vision improved with conservative treatment were significantly lower than the number of cases with surgical treatment(P<0.05).

CONCLUSION: The surgical treatment is still visible vitreous hemorrhage treatment means of positive, but there will be eyeball atrophy and other serious complications, so we should choose a different methods in according to the different treatment objects and treatment time.