贺诗慧

【摘要】 目的：研究25G玻璃体切除联合空气填充术对孔源性视网膜脱离患者视网膜复位及视力的影响。方法：选择2022年1—12月贵州省人民医院收治的98例孔源性视网膜脱离患者，根据随机数字表法分为观察组（25G玻璃体切除联合空气填充术）49例和对照组（25G玻璃体切除联合硅油填充术）49例，比较两组视网膜复位、视力及视网膜厚度。结果：观察组手术时间、术后俯卧时间均短于对照组（P<0.05）；两组视网膜复位率比较差异无统计学意义（P>0.05）。两组术后6个月最佳矫正视力（BCVA）均降低，且观察组低于对照组（P<0.05）。对照组术后6个月患眼内环区上、下及黄斑中央凹区视网膜厚度均较术前降低，且均低于观察组（P<0.05），观察组术前与术后6个月上述指标比较差异均无统计学意义（P>0.05）。观察组围手术期并发症发生率低于对照组（P<0.05）。结论：25G玻璃体切除联合空气填充术对孔源性视网膜脱离患者视网膜复位的作用与25G玻璃体切除联合硅油填充术相当，更利于促进视力恢复，且能减小对视网膜厚度的影响，降低围手术期并发症发生率。

【关键词】 孔源性视网膜脱离 玻璃体切除 视力

The Effect of 25G Vitrectomy Combined with Air Tamponade on Retinal Reattachment and Visual Acuity in Patients with Rhegmatogenous Retinal Detachment/HE Shihui. //Medical Innovation of China， 2024， 21（14）： -119

[Abstract] Objective： To study the effect of 25G vitrectomy combined with air tamponade on retinal reattachment and visual acuity in patients with rhegmatogenous retinal detachment. Method： A total of 98 patients with rheogenous retinal detachment admitted to Guizhou Provincial People's Hospital from January to December 2022 were selected， according to the random number table method， they were divided into observation group （25G vitrectomy combined with air tamponade） 49 cases and control group （25G vitrectomy combined with silicone oil tamponade） 49 cases. The retinal reduction， visual acuity and retinal thickness of the two groups were compared. Result： The operation time and prone lying time in the observation group were shorter than those in the control group （P<0.05）; there was no significant difference in retinal reattachment rate between the two groups （P>0.05）. The best corrected visual acuity （BCVA） at 6 months after operation was decreased in both groups， and the observation group was lower than that of the control group （P<0.05）. In the control group， the retinal thickness in the upper and lower inner ring area and the fovea of macula were decreased 6 months after operation， all of them were lower than those in observation group （P<0.05）; there were no significant differences in the above indexes between the observation group before operation and 6 months after operation （P>0.05）. The incidence of perioperative complications in observation group was lower than that in control group （P<0.05）. Conclusion： The effect of 25G vitrectomy combined with air tamponade on retinal reduction in patients with rheogenic retinal detachment is similar to that of 25G vitrectomy combined with silicone oil tamponade， which is more conducive to visual recovery， and can reduce the influence on retinal thickness and reduce the incidence of perioperative complications.

[Key words] Rhegmatogenous retinal detachment Vitrectomy Vision

First-author's address： Ophthalmology Department， Guizhou Provincial People's Hospital， Guiyang 550000， China

doi：10.3969/j.issn.1674-4985.2024.14.028

孔源性视网膜脱离是一种视网膜脱离的形式，其中视网膜在黄斑区周围发生脱离，而黄斑区本身保持连接[1]。孔源性视网膜脱离可能会造成视网膜与营养供应的脉络膜之间的分离，使得受影响的部分无法正常接收到营养和氧气，导致视力模糊、失明或视野缺损，对患者的视力和生活质量产生危害[2]。视网膜脱离是一种紧急情况，及早进行手术可以最大限度地恢复受影响区域的视网膜，并尽可能保护患者的视力。未经治疗的视网膜脱离可能会进一步扩展，导致更大范围的视网膜受损，增加治疗难度和风险。25G玻璃体切除手术是一种微创手术技术，使用极细的器械进行切除和修复[3]。相比传统的20G或23G手术，25G手术具有更小的切口和更少的术后并发症风险。在这种手术中，医生使用25G的切口进入眼球内部，通过显微镜引导下进行玻璃体切除操作，修复视网膜脱离[4]。……