|本期目录/Table of Contents|

[1]郑惠.23G高速玻璃体切除术联合抗病毒药物对急性视网膜坏死综合征的治疗[J].医学研究与战创伤救治(原医学研究生学报),2017,19(03):261-263.[doi:10.3969/j.issn.1672-271X.2017.03.010]
　ZHENG Hui.23G high-speed vitrectomy combined with antiviral totreat acute retinal necrosis syndrome[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2017,19(03):261-263.[doi:10.3969/j.issn.1672-271X.2017.03.010]
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23G高速玻璃体切除术联合抗病毒药物对急性视网膜坏死综合征的治疗()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第19卷
期数:
2017年03期
页码:
261-263
栏目:
出版日期:
2017-05-20

文章信息/Info

Title:
23G high-speed vitrectomy combined with antiviral totreat acute retinal necrosis syndrome
作者:
郑惠
作者单位：100026北京，北京华德眼科医院眼科
Author(s):
ZHENG Hui
（Department of Ophthalmology,Beijing Huade Eye Hospital,Beijing 100026,China）
关键词:
视网膜坏死; 玻璃体混浊; 玻璃体切除; 23G; 高速
Keywords:
Retinal necrosis;  Vitreous opacities;  Vitrectomy;  23G;  High speed
分类号:
R77
DOI:
10.3969/j.issn.1672-271X.2017.03.010
文献标志码:
A
摘要:
目的 分析23G高速玻璃体切除术联合全身抗病毒药物对急性视网膜坏死综合征（acute retinal necrosis syndrome,ARN）的治疗方法 及治疗效果。方法 回顾性分析2012年6月至2015年1月北京华德眼科医院收治的16例（16眼）ARN患者临床资料。视力:光感-指数/眼前9眼,4眼0.03～0.07,3眼0.1～0.3。16例患者来院前均未确诊。玻璃体均灰黄色致密混浊，6眼隐约见视网膜灰白的坏死灶、视网膜片状出血、视网膜血管闭塞，周边部视网膜成筛网状裂孔，1眼上方视网膜缺失、脉络膜暴露，9眼眼底窥不入。6眼牵拉性视网膜脱离，1眼伴有黄斑区裂孔。入院后均常规给予抗病毒及激素治疗。16眼均行微创23G高速玻璃体切除手术治疗，其中15眼联合玻璃体内硅油充填，1眼联合全氟丙烷(C3F8)充填。结果 术后随访1年,16眼中光感2眼，指数/眼前2眼，8眼视力0.05～0.1,4眼视力0.1～0.5。16眼中有1例虹膜炎症反复发作。联合硅油充填的15眼均不同程度并发白内障，10眼术后6～8个月行硅油取出联合白内障超声乳化人工晶体植入术。16例患者术中、术后均未发生玻璃体手术并发症。结论 23G微切口高速玻璃体切除手术联合全身抗病毒及激素治疗可有效控制病情的发展，视力有不同程度的提高。同时23G微切口手术联合高速玻切行急性视网膜坏死综合征的玻璃体切除可有效预防术中、术后并发症的发生。
Abstract:
Objective To analyze the efficacy of 23G high-speed vitrectomy combined with systemic antiviral drugs as the treatment for acute retinal syndrome (acute retinal necrosis syndrome, ARN).Methods Retrospectively analyzed 16 ARN patients from June 2012 to January 2015 in Beijing Huade Eye Hospital with 16 eyes. Vision: nine in light perception-Index/front, four between 0.03-0.07, three visual 0.1-0.3.16 patients were not diagnosed before adiministration. Vitreums were all pale yellow dense vitreous opacities. 6 cases of retinal had faint gray necrosis, retinal haemorrhage, retinal vascular occlusion, and a mesh-like peripheral retinal hole. One eye missed the top of the retina, with choroid exposure. For nine eyes, fundus could not be seen. Six eyes were traction retinal detached and one eye with a macular hole. After admission, all patients were routinely given anti-viral and hormone therapy. 16 patients underwent minimally invasive 23G vitrectomy surgery, in which 15 combinied intravitreal silicone oil, a joint C3F8 filling.Results 1-year postoperative follow-up was performed with16 eyes, and there were 2 eyes light perception, two index / front, eight visual acuity 0.05-0.1, and four visual acuity 0.1-0.5. Recurrent inflammation of iris occurred in 1 cases. For the 15 eyes combined with silicone oil filling cataract were saw in different grades. Postoperative 6-8 months, oil removal and cataract ultrasonic emulsification and intraocular lens implantation was given to 10 eyes. There were no postoperative complications with vitreous surgery in all 16 eyes.Conclusion 23G high-speed micro-incision vitrectomy combined with systemic anti-viral and hormone therapy can effectively control the disease progresses, and improve vision to varying degrees. Meanwhile, 23G micro-incision vitrectomy combined with high-speed lines to treat acute retinal necrosis syndrome vitrectomy may be effective in preventing intraoperative and postoperative complications.

参考文献/References:

[1]任丹,陈莲.急性视网膜坏死综合征15例临床研究[J]. 中国现代手术学杂志,2012,16(2):151-153.
[2］谢阳,卢国华,毛平安,等.23-G高速微创玻璃体切割系统在玻璃体视网膜疾病的应用[J]. 国际眼科杂志,2012,12(12):2371-2372.
[3］Gupta M, Jardeleza MS, Kim I, et al. Varicella zoster virus necrotizing retinitis in two patients with idiopathic CD4 lymphocytopenia[J]. Ocul Immunol Inflamm,2016,24(5):544-548.
[4］Shibata M, Sato T, Taguchi M, et al. Analysis of cytokines related to helper T and regulatory T cells in the vitreous of uveitis patients[J]. Nippon Ganka Gakkai Zasshi,2015,119(6):395-401.
[5］李杰,刘三梅,李芳,等.27G微创玻璃体切除手术的发展及应用[J]. 国际眼科杂志,2016,16(8):1483-1486.
[6］Winterhalter S, Stuebiger N, Maier AK, et al.Acute retinal necrosis: diagnostic and treatment strategies in Germany[J]. Ocul Immunol Inflamm,2016,24(5):537-543.
[7］Navarro-Navarro A,Martinez-Toldos JJ, Tarazona-Jaimes CP, et al. Presumed bilateral acute retinal necrosis 11 years apart,atypical presentation, and early vitrectomy[J]. Eur J Ophthalmol,2015,25(5):e81-83.
[8］周楠,杨翠芳.23G微创无缝合玻璃体切除术治疗视网膜脱离的手术配合[J]. 天津护理,2014,22(4):325.
[9］AlQahtani A, Touitou V, Cassoux N, et al. More than a masquerade syndrome: atypical presentations of vitreoretinal lymphomas[J]. Ocul Immunol Inflamm,2014,22(3):189-196.
[10]Arruti M, Aldazabal M, Blanco A, et al. Acute herpes simplex virus type 1 retinal necrosis three years after herpes simplex encephalitis[J]. Rev Neurol,2014,58(1):45-46.
[11]王卫星,王淑华,万阳艳,等.超高速23G微创玻璃体切除术治疗复杂性视网膜脱离[J]. 江西医药,2014,21(4):355-357.
[12]Shahi SK. Acute retinal necrosis results in low vision in a young patient with a history of herpes simplex virus encephalitis[J]. Clin Exp Optom,2017,100(3):208-213.
[13]Shantha JG, Weissman HM, Debiec MR, et al.Advances in the management of acute retinal necrosis[J]. Int Ophthalmol Clin,2015,55(3):1-13.
[14]陈宏.23G微创玻璃体切除治疗黄斑裂孔性视网膜脱离的围手术期护理[J]. 中国实用护理杂志,2013,29(2):24-25.
[15]Matsuo T. Timing of prophylactic and early vitrectomy for first-presenting or recurrent acute retinal necrosis syndrome[J]. Acta Med Okayama,2012,66(6):493-497.
[16]石尧，吴艳，尹婕,等.玻璃体切割眼内光凝硅油充填治疗急性视网膜坏死综合征[J]. 医学研究生学报,2009,22(7):722-724.
[17]王晓蕾,王朱健,汤荔,等.青光眼睫状体炎综合征房水CMV IgG抗体白蛋白校正比值的研究[J]. 中华眼科杂志,2017,53(2):104-108.
[18]王慧芳,李才锐,马麦聪,等.病毒性脑炎合并急性视网膜坏死一例[J]. 中华眼底病杂志,2017,33(1):78-80

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更新日期/Last Update: 2017-05-20