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題名 | Balanced Fluid Exchange by Volume Homeostatic Fluid-Fluid Exchanger-A New Solution to Postvitrectomy Vitreous Hemorrhage=以體積恆定液體交換儀進行平衡液體交換術--處理玻璃體切除術後再出血的新方法 |
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作者 | 陳征宇; 吳文權; 陳明琮; 王惠珠; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷期 | 13:11 1997.11[民86.11] |
頁次 | 頁700-703 |
分類號 | 416.745 |
關鍵詞 | 體積恆定液體交換儀; 平衡液體交換術; 玻璃體切除術後; 再出血; Postvitrectomy vitreous hemorrhage; Vitreous cavity lavage; Balanced fluid exchange; |
語文 | 英文(English) |
中文摘要 | 糖尿病視網膜病變經玻璃體切除術後產生再出血之比率可達29%.75%。目前常用來處理此種再出血的手術方法有液氣交換術 (Fluid-Gas Exchange) 與玻璃體腔灌洗術 (Vitreous Cavity Lavage) 兩類。其中液氣交換術無法使病人在術後馬上得到視力的改善。玻璃體腔灌洗術雖然有可能使病人的親力在術後馬上得到改善,但仍有手術中眼壓無法維持穩定與必須使用大口徑針頭引流血水之缺點。此引流針頭口徑雖大但因其仍無法主動抽取血水,所以常會被血液凝塊阻塞而影響手術之進行。 為改善傳統玻璃體腔灌洗術之缺點,吾人設計一“體積恆定液體交換儀”(Homeostatic Fluid-Fluid Exchanger)。此裝置可在局部麻醉下使用兩支小口徑針頭於玻璃體腔進行等量體積之液體交換。因其提供同時且等量的血水抽除與溶液灌注之功能,故此液體交換儀可隨時維持手術中眼壓之穩定:因為灌注與抽吸進行的方式都是主動的,所以可使用小至27號的針頭便可順利進行液體交換;進行液體交換時不但可將小血液凝塊吸出,若有大血液凝塊塞住吸引針頭而無法吸除時,亦可經由暫時反方向的操作將吸入物吐出,再重新進行液體交換而不影響到眼內壓的穩定。因主動液體交換的方式是等量且同步的,故吾人稱此改進後的玻璃體腔灌洗術為“平衡液體交換術” (Balanced Fluid Exchange)。 以體積恆定液體交換儀於局部麻醉下進行平衡液體交換術,除了可減少手術對眼球組織之傷害外,並可減少因眼壓變動所產生之併發症,進而提高術中與術後玻璃體腔出血的廓清率,對於玻璃體切除術後所產生的再出血提供一種新的手術方法。目前此平衡液體交換術已於臨床上運用於多位玻璃體切除術後再出血的病患,均得到良好的治療效果,是一可信賴之手術方法。 |
英文摘要 | We Introduce a new device and a new technique that facilitate the clearance of postvitrectomy vitreous hemorrhage. We have developed a volume homeostatic fluid fluid exchanger - Chen's Infusion/Aspiration (Chen's 1/A) device. Due to reciprocal synchronized hydraulic action, Chen's I/A provides simultaneous Infusion and aspiration of fluid of equal amounts. Therefore, It can be used to perform vitreous cavity lavage through smaller calther needles and at the same time maintain a constant tntraocular pressure. This Improved vitreous cavity lavage technique Is named Balanced Fluid Exchange. Performing Balanced Fluid Exchange with Chen's 1/A can reduce trauma to the eyeball and decrease complications resulting from unstable lntraocular pressure. Thus, It Increases both the lntra-operative and post-operative clearance rates of postvitrectomy vitreous hemorrhage, and Is a promising method for the management of postvitrectomy vitreous hemorrhage. |
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