[关键词]
[摘要]
目的:比较经传统球结膜切口和微创球结膜切口行巩膜外加压术对单纯性孔源性视网膜脱离手术效果及术后舒适度的影响。
方法:随机对照临床试验。选择2016-08/2018-11在我院眼科接受手术治疗的单纯性孔源性视网膜脱离患者80例80眼,随机分成两组,均接受巩膜外加压术联合术后光凝封闭裂孔,对照组40例40眼采用传统球结膜切口,试验组40例40眼采取微创球结膜切口。记录手术用时,术后1d经裂隙灯检查视网膜复位情况,并采用视觉模拟评分法(VAS)评价疼痛情况,术后1、7、14、30d以问卷形式评价术后舒适度。
结果:两组患者均顺利完成手术,试验组患者手术用时明显短于对照组(55.13±2.77min vs 56.63±3.69min,P=0.043)。术后1d,两组患者裂孔均位于术嵴中央或前坡上,裂孔周围视网膜复位良好,但试验组患者疼痛感明显小于对照组,且术后1、7d试验组患者舒适度明显高于对照组。
结论:采用微创球结膜切口可以缩短手术时间,明显减少患者术后疼痛及不适感。
[Key word]
[Abstract]
AIM: To compare the postoperative outcomes after segmental scleral buckling(SSB)surgery with minimal
in situ conjunctival incision(MCI)and conventional limbal conjunctival incision(LCI).
METHODS: Prospective randomized controlled study. Eighty eyes of 80 patients with rhegmatogenous retinal detachment(RRD)who received SSB surgeries in our hospital from August 2016 to November 2018 were recruited. They were randomly divided into two groups. Patients in control group were performed with conventional LCI, while patients in observation group received MCI. The length of the surgery, the retinal reattachment rate and the visual analogue scale(VAS)for evaluating the pain on the first postoperative day, questionnaire scoring method for evaluating the postoperative comfort level(including foreign body sensation and tearing)on the first, seventh, fourteenth, and thirtieth days were recorded.
RESULTS: The difference of surgery time between the control group and the observation group was statistically significant(t=2.057, P<0.05). There was no significance in retinal reattachment rate between two groups. At the first day after surgery, the postoperative pain of the observation group was significantly lower than the control group(P<0.05). At the first and seventh day after surgery, the observation group had higher postoperative comfort questionnaire score than the control group(P<0.01), however, at the fourteenth and thirtieth day after surgery, the score was similar between the two groups(P>0.05).
CONCLUSION: Using MCI in SSB operation could shorten the operation time and significantly reduced postoperative pain and discomfort level.
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[基金项目]
西安交通大学第一附属医院科研发展基金(No. 2015YK25); 西安交通大学第一附属医院新医疗新技术项目(No. XJYFY-2016W26,XJYFY-2017W61)