山东大学耳鼻喉眼学报 ›› 2023, Vol. 37 ›› Issue (1): 80-84.doi: 10.6040/j.issn.1673-3770.0.2021.455

• 论著 • 上一篇    

两种自制简易装置取出玻璃体硅油的方法

栾国刚1,谌金金2,严涛2   

  1. 1. 宜昌市爱尔眼科医院 眼科, 湖北 宜昌 443000;
    2. 宜昌市第一人民医院/三峡大学人民医院 眼科, 湖北 宜昌 443003
  • 发布日期:2023-02-06
  • 通讯作者: 严涛 E-mail:182029902@qq.com

Two methods of vitreous silicone oil extraction with self-made simple devices

LUAN Guogang1, CHEN Jinjin2, YAN Tao2   

  1. 1. Department of Ophthalmology, Yichang Aier Eye Hospital, Yichang 443000, Hubei, China;
    2. Department of Ophthalmology, Yichang First People's Hospital / People's Hospital of Three Gorges University, Yichang 443003, Hubei, China;
  • Published:2023-02-06

PDF (PC)

102

摘要： 目的 探讨自制研发用于玻璃体硅油取出两种简易装置的可行性。 方法 选取因孔源性视网膜脱离、视网膜附着稳定的患者200例200 眼,硅油填充术后 3~6个月。采用完全随机化分组分为2个组。第一组有102例,20G通道20GY型静脉留置套管针制作简易取油器具取硅油,20G笛针行气液交换取出残余硅油;第二组98例,将输血管直管两端垂直剪断,保留长度为5 mm,一端套在23G取油穿刺套管上,另一端连接20 mL注射器取油,23G笛针行气液交换取出残余硅油; 结果 第一组与第二组在硅油取出时间长度的比较差异无统计学意义［(4.65±1.52)min vs(4.85±2.02)min,t=1.38,P=0.14］;第一组与第二组间气液交换时间的比较差异有统计学意义［(1.25±0.51)min vs(2.16±1.24)min,t=8.34,P=0.003］;第一组与第二组间的眼压在术前及术后1 d、4 d、1周、1个月等时间的比较差异无统计学意义(P>0.05);第一组与第二组间在感染率、出血率、视网膜脱离复发率等并发症之间的比较差异无统计学意义(P>0.05);第一组患者的硅油残留率低于第二组患者,两组间的比较差异有统计学意义(5.10% vs 19.61%,P=0.002); 结论 行单纯硅油取出,两种取油方法均是安全有效的。但气液交换时间及硅油残留率,20G Y型静脉留置针制作取油器联合20G笛针更有优势。

关键词: 硅油取出, 20G Y型静脉留置针, 20、23G笛针, 气液交换, 并发症

Abstract: Objective This study aimed to investigate the feasibility of using two simple devices for vitreous silicone oil extraction. Methods Overall, 200 eyes of 200 patients with rhegmatogenous retinal detachment and stable retinal attachment after silicone oil filling for 3-6 months were selected. The patients were randomly divided into two groups. Group one composed of 102 patients who were treated with 20G Y intravenous indwelling trocar to make a simple oil-extracting device to get silicone oil by 20G channel. Subsequently, a 20G flute needle was used for gas-liquid exchange to remove residual silicone oil. Group two composed of 98 patients. The two ends of the straight blood transfusion tube were vertically cut with a retention length of 5 mm. One end was set on the 23G oil extraction cannulas and the other end was connected with a 20 mL syringe for oil extraction. The 23G flute needle was used for gas-liquid exchange to remove residual silicone oil. Results There was no significant difference in the removal time between groups one and two(［4.65±1.52］ min vs ［4.85±2.02］ min, T=1.38, P=0.14). There was a significant difference for the gas-liquid exchange time between groups one and two(［1.25±0.51］ min vs ［2.16±1.24］ min, T=8.34, P=0.003). There was no significant difference in the intraocular pressure between the two groups preoperatively and postoperatively for 1 day, 4 days, 1 week, and 1 month(P>0.05). There were no significant differences in the infection rate, bleeding rate, and recurrence rate for retinal detachment between the two groups(P>0.05). The silicone oil residual rate in group one was lower than that in group two and was statistically different(5.10% vs 19.61%, P=0.002). Conclusion The two methods are safe and effective for silicone oil extraction. However, 20G Y vein indent needle combined with 20G flute needle is more advantageous in terms of the gas-liquid exchange time and silicone oil residual rate.

Key words: Silicone oil extraction, 20GY vein indwelling trocar, 20G channel, 23G flute needle, Gas-liquid exchange, Complication

中图分类号: 

  • R774.1
[1] Gonzalez MA, Flynn HW Jr, Smiddy WE, et al. Giant retinal tears after prior pars Plana vitrectomy: management strategies and outcomes[J]. Clin Ophthalmol, 2013, 7: 1687-1691. doi:10.2147/OPTH.S48930
[2] Alkabes M, Padilla L, Salinas C, et al. Assessment of OCT measurements as prognostic factors in myopic macular hole surgery without foveoschisis[J]. Albrecht Von Graefes Arch Fur Klinische Und Exp Ophthalmol, 2013, 251(11): 2521-2527. doi:10.1007/s00417-013-2347-y
[3] Garnier S, Rahmi A, Grasswil C, et al. Three hundred and sixty degree retinotomy for retinal detachments with severe proliferative vitreoretinopathy[J]. Albrecht Von Graefes Arch Fur Klinische Und Exp Ophthalmol, 2013, 251(9): 2081-2085. doi:10.1007/s00417-013-2298-3
[4] Mangouritsas G, Mourtzoukos S, Portaliou DM, et al. Glaucoma associated with the management of rhegmatogenous retinal detachment[J]. Clin Ophthalmol, 2013, 7: 727-734. doi:10.2147/OPTH.S42792
[5] 陈钰虹, 项潇琼, 朱鸿, 等. 光学相干断层扫描血管成像技术评估孔源性视网膜脱离患者行玻璃体切割联合气体或硅油填充术后的黄斑区血流变化[J]. 上海交通大学学报(医学版), 2019, 39(6): 605-612. doi:10.3969/j.issn.1674-8115.2019.06.008 CHEN Yuhong, XIANG Xiaoqiong, ZHU Hong, et al. Macular blood flow changes assessed by optical coherence tomography angiography after pars Plana vitrectomy with gas or silicone oil tamponade for the patients with rhegmatogenous retinal detachment[J]. Journal of Shanghai Jiao Tong University(Medical Science), 2019, 39(6): 605-612. doi:10.3969/j.issn.1674-8115.2019.06.008
[6] 许菁, 王方. 硅油对视神经的毒性作用[J]. 国际眼科杂志, 2019, 19(5): 787-790. doi:10.3980/j.issn.1672-5123.2019.5.18 XU Jing, WANG Fang. Toxic effect of silicone oil on optic nerve[J]. International Eye Science, 2019, 19(5): 787-790. doi:10.3980/j.issn.1672-5123.2019.5.18
[7] Matic S, Suic SP, Biuk D, et al. Influence of silicone oil tamponade after vitrectomy on intraocular pressure[J]. Coll Antropol, 2013, 37(Suppl 1): 227-235
[8] 孔德菊, 于旭辉. 硅油填充术后继发高眼压的相关危险因素[J]. 国际眼科杂志, 2018, 18(11): 2003-2006. doi:10.3980/j.issn.1672-5123.2018.11.13 KONG Deju, YU Xuhui. Risk factors of secondary intraocular hypertension after silicone oil tamponade[J]. International Eye Science, 2018, 18(11): 2003-2006. doi:10.3980/j.issn.1672-5123.2018.11.13
[9] Zhang ZT, Wei YT, Jiang XT, et al. A machine-independent method to have active removal of 5, 000 centistokes silicone oil using plastic infusion tube and 23-gauge microcannulas[J]. BMC Ophthalmol, 2015, 15: 114. doi:10.1186/s12886-015-0103-2
[10] 阮建祥, 陈春霞, 钱莉, 等. 改良注射器负压在硅油限速取出术中的临床应用[J]. 临床眼科杂志, 2020, 28(2): 166-169. doi:10.3969/j.issn.1006-8422.2020.02.017 RUAN Jianxiang, CHEN Chunxia, QIAN Li, et al. Clinical application of negative pressure generated by the modified syringe in silicone oil removal with limited speed[J]. Journal of Clinical Ophthalmology, 2020, 28(2): 166-169. doi:10.3969/j.issn.1006-8422.2020.02.017
[11] Song ZM, Chen D, Ke ZS, et al. A new approach for active removal of 5, 000 centistokes silicone oil through 23-gauge Cannula[J]. Retina, 2010, 30(8): 1302-1307. doi:10.1097/IAE.0b013e3181e09841
[12] 吴荣瀚, 林仲, 梁奇华, 等. 玻璃体切割术后三种硅油取出方法比较[J]. 中华眼视光学与视觉科学杂志, 2018, 20(4): 209-215. doi:10.3760/cma.j.issn.1674-845X.2018.04.004 WU Ronghan, LIN Zhong, LIANG Qihua, et al. Comparison of three methods for intraocular silicone oil removal[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2018, 20(4): 209-215. doi:10.3760/cma.j.issn.1674-845X.2018.04.004
[13] 冀垒兵,杨永利,辛文剑.自制23G抽吸器进行硅油取出术临床效果观察[J].中华眼外伤职业病杂志 2018, 40(12):911-915. doi:10.3760/cma.j.issn.2095-1447.2018.12.009 JI Lei bing, Yang Yongli, XinWenjian. Observation on the efficacy of silicone oil removal with self-made 23 G suction unit[J]. Chin J Ocul Traum Occupat Eye Dis, 2018, 40(12):911-915. doi:10.3760/cma.j.issn.2095-1447.2018.12.009
[14] 杨加富, 宋瑜, 侯帅, 等. 医用注射器抽吸压力的测定[J]. 中国美容整形外科杂志, 2010, 21(12): 734-736. doi:10.3969/j.issn.1673-7040.2010.12.011 YANG Jiafu, SONG Yu, HOU Shuai, et al. Measurement of aspiration pressure of medical syringe[J]. Chinese Journal of Aesthetic and Plastic Surgery, 2010, 21(12): 734-736. doi:10.3969/j.issn.1673-7040.2010.12.011
[15] 柯治生, 宋宗明, 王瑞华. 微创玻璃体切割系统在硅油取出术中的应用[J]. 中国实用眼科杂志, 2010, 28(1): 72-74. doi:10.3760/cma.jssn.1006-4443.2010.01.023 KE Zhisheng, SONG Zongming, WANG Ruihua. The application of micro-incision vitrectomy system in the method to remove silicone oil combined with secondary posterior chamber intraocular lens implantation[J]. Chinese Journal of Practical Ophthalmolog, 2010, 28(1): 72-74. doi:10.3760/cma.jssn.1006-4443.2010.01.023
[16] 田磊, 刘金梅. 气液交换在硅油取出术中应用的效果[J]. 中华眼外伤职业眼病杂志, 2020, 42(6): 470-473. doi:10.3760/cma.j.cn116022-20191215-00423 TIAN Lei, LIU Jinmei. Efficacy of application of air-fluid exchange during silicone oil removal[J]. Chinese Journal of Ocular Trauma and Occupational Eye Disease, 2020, 42(6): 470-473. doi:10.3760/cma.j.cn116022-20191215-00423
[17] 雷建平. 23G与20G玻璃体切割系统在硅油取出术中的对比研究[J]. 国际眼科杂志, 2016, 16(10): 1832-1835. doi:10.3980/j.issn.1672-5123.2016.10.11 LEI Jianping. Comparison of 23 G and 20 G vitreous cut system in silicone oil extracting operation[J]. International Eye Science, 2016, 16(10): 1832-1835. doi:10.3980/j.issn.1672-5123.2016.10.11
[18] Oh HJ, Chang W, Min SG. Efficacy and safety of active silicone oil removal through a 23-gauge transconjunctival Cannula using an external vacuum pump[J]. Int J Ophthalmol, 2015, 8(2): 347-352. doi:10.3980/j.issn.2222-3959.2015.02.24
[19] 李璐希, 王雨生, 李曼红, 等. 缝合切口与否对25G玻璃体切割术后患者眼压及相关并发症的影响[J]. 眼科新进展, 2018, 38(7): 664-668. doi:10.13389/j.cnki.rao.2018.0156 LI Luxi, WANG Yusheng, LI Manhong, et al. Clinical observation of postoperative intraocular pressure and complication for 25-gauge transconjunctival suture and sutureless vitrectomy[J]. Recent Advances in Ophthalmology, 2018, 38(7): 664-668. doi:10.13389/j.cnki.rao.2018.0156
[20] Brazitikos PD, Androudi S, Christen WG, et al. Primary pars Plana vitrectomy versus scleral buckle surgery for the treatment of pseudophakic retinal detachment: a randomized clinical trial[J]. Retina, 2005, 25(8): 957-964. doi:10.1097/00006982-200512000-00001
[1] 冯燚源,杨晶,杨洪斌. 220例颈深间隙感染临床分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 51-57.
[2] 李莹. 重视角膜屈光手术操作规范及并发症防治[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 1-6.
[3] 次仁琼达, 吴元. 中毒性表皮坏死松解症导致眼部远期并发症1例[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 147-150.
[4] 赵雅铭,石崧. 以急性会厌炎为首诊的3例颈部坏死性筋膜炎病例报告并文献复习[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 12-16.
[5] 孙川,刘亚群,何双八,张庆翔. 低温等离子辅助经鼻切除前中颅底肿瘤17例[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 55-59.
[6] 魏佩佩,李灿. 多焦点人工晶体植入术后的视觉质量及并发症[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 141-146.
[7] 房忠菊, 张永侠, 赵建东, 纵亮, 翟性友, 李新建, 彭新, 任楠, 陈立伟, 刘明波. 甲状腺癌颈清扫术后乳糜漏的综合治疗[J]. 山东大学耳鼻喉眼学报, 2020, 34(3): 64-68.
[8] 苏才培,杨亚波. 飞秒激光小切口角膜基质透镜取出术操作要点及并发症的预防和处理[J]. 山东大学耳鼻喉眼学报, 2020, 34(2): 13-16.
[9] 王暄琪,陈珣,王晓瑛. 可植入式眼内镜术后拱高及相关因素[J]. 山东大学耳鼻喉眼学报, 2020, 34(2): 72-78.
[10] 张婵媛, 孙玉霖, 王琳, 张莉, 陈敏, 于龙刚, 李娜, 崔鑫, 姜彦. 儿童鼻窦炎眶并发症诊治31例及文献分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 34-40.
[11] 朱鲁平, 陈娟, 朱垒, 陈仁杰. 儿童急性鼻窦炎合并肾小球肾炎及眶内脓肿一例[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 41-44.
[12] 黄纪逸,李柏滋,吴树浓,吕正华. 咽腭弓肌黏膜瓣闭合扁桃体等离子术后创面的临床疗效[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 92-95.
[13] 王盼盼. 基于品管圈出院计划管理对耳畸形再造术后康复的影响[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 165-168.
[14] 邱前辉,陈卓. 鼻内镜手术治疗首诊局部晚期鼻咽癌及放疗后严重并发症的作用[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 17-20.
[15] 王振霖,刘俊其. 鼻咽癌外科治疗中的颈内动脉保护[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 21-25.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发