内眼手术及外伤术后迟发型脉络膜上腔出血的处理-《眼科新进展》

文章信息/Info

Title:: Management of delayed suprachoroidal hemorrhage after intraocular surgery and trauma

Author(s):: JIN Wei; YANG An-Huai ; XING Yi-Qiao ; WANG Wen-Jun; Department of Ophthalmology ,Renmin Hospital of Wuhan University , Wuhan 430060 , Hubei Province , China

Keywords:: delayed s suprachoroidal hemorrhage ; early intervention ; risk factor

摘要:: 目的　探讨迟发型脉络膜上腔出血（ｄｅｌａｙｅｄｓｕｐｒａｃｈｏｒｉｏｄａｌｈａｅｍｏｒｒｈａｇｅ，ＤＳＣＨ）的手术相关危险因素，并分析分步手术治疗ＤＳＣＨ的效果。方法　分析２００７年７月至２０１２年１２月在我院诊断为ＤＳＣＨ的１０例（１０眼）患者，收集并分析临床数据，包括眼底检查、眼部Ｂ超、手术方式的选择、术后视力和眼压等。结果　１０例（１０眼）患者中男６例，女４例，年龄（５６．６０±１７. ６７）岁。８例患者行巩膜切开引流术或／和玻璃体切割术，另２例行保守治疗。随访时间为（１５．２±４．３）个月。所有患者接受手术后眼压明显降低，视力明显提高，差异均有统计学意义（均为Ｐ＜０．０１）。结论　术中使用丝裂霉素Ｃ，全身使用抗凝剂或溶栓剂及慢性肾病是ＤＳＣＨ的危险因素。一旦确诊为ＤＳＣＨ，早期进行手术干预将会为患者的预后带来更好的视力。

Abstract:: Objective To indentify surgical risk factors for delayed suprachoroidal hemorrhage ( DSCH) . and report the outcomes of effective intervention in a consecutive of patients. Methods The clinical data of 10 patients diagnosed with DSCH in our hospital from July 2007 to December 2012 were extracted from hospital records and analyzed , including ophthalmologic examination , ophthalmologic B ultrasound , surgical procedures and outcome measures including visual acuity and intraocular pressure. Results The 10 eyes of 10 patients included 6 men and 4 women, with age of (56. 60 + 17. 67 ) years. After diagnosis , drainage or/and pars plan vitrectomy were performed in 8 cases , another 2 cases received conservative treatment. All the patients were followed up for ( 15. 2 + 4. 3 ) months. The postoperative intraocular pressure in all patients decreased significantly , and the visual acuity increased . there were significant differences ( all P < 0. 001) . Conclusion The intraoperative mitomycin-C using , systemic anticoagulation or thrombolysis , chronic kidney disease are the risk factors for DSCH. It seems that earlier surgical intervention after the diagnosis of DSCH will be beneficial to the patients by improving their final visual acuity.