摘要
目的探讨康柏西普联合微创玻璃体切除术治疗增生性糖尿病视网膜病变的疗效及安全性。方法回顾性分析2015年3月至2017年2月增生性糖尿病视网膜病变患者168例(168患眼,均为单眼),根据患者治疗方法的不同分为A组(57例)、B组(55例)、C组(56例),A组:25G玻璃体微创手术+玻璃体腔注射康柏西普(术前、术后);B组:玻璃体腔注射康柏西普(术前)+25G玻璃体微创手术;C组:25G玻璃体微创手术。观察对比各组25G玻璃体微创手术所用时间,术中、术后(3个月、6个月)最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)。术后6个月判定各组视力改善情况。结果 A组和B组平均手术时间均较短,C组手术用时最长(P<0.05),术中C组明显出血、医源性视网膜裂孔发生率以及电凝止血频率最高,A组和B组平均手术时间及术中情况比较,差异无统计学意义(P>0.05);术后3个月、6个月BCVA、CMT均较术前明显改善,A组与B组比较差异无显著性(P>0.05),A组和B组均优于C组(P<0.05);术后6个月,A组视力改善率为84.21%,高于B组(74.55%)与C组(553.57%)(P<0.05);A组在术后1个月内玻璃体出血发生率、再次手术率以及术后激光补充次数均低于其他两组,而晚期出血、牵拉性视网膜脱离(TRD)、高眼压发生率C组最高,A组与B组差异无显著性(P>0.05)。结论微创玻璃体切除术术前、术后均行玻璃体腔内注射康柏西普可有效治疗增生性糖尿病视网膜病变,安全性佳,且相对单纯微创玻璃体切除术或仅术后球内注射康柏西普更具优势。
Objective To analyze the curative effect and safety of Compaq heap combined with minimally invasive vitrectomy for treatment of proliferative diabetic retinopathy. Methods From March 2015 to February 2017,168 patients of proliferative diabetic retinopathy（ 168 monocular eye） were divided into group A（ 57 cases）,group B（ 55 cases） and group C（ 56 cases）. Group A： 25 g vitreous body cavity injection of minimally invasive surgery ＋ glass compaq heap（ preoperative and postoperative）. Group B： glass body cavity injection of compaq heap（ preoperative） ＋ 25 g vitreous minimally invasive surgery; Group C： 25 g vitreous minimally invasive surgery. 25 g used vitreous minimally invasive surgery time,intraoperative and postoperative BCVA（ 3 months,6 months）,the CMT were compared. At 6 months after the operation,vision improvement was determined. Results The average operation time in Group A and group B were shorter,group C was the longest（ P〈0. 05）. In group C,bleeding was significant,and the incidence of iatrogenic retinal prespliting and an electrocautery unit of blood frequency were highest,but there was no statistically significant difference of bleeding and status in the operation in group A and group B（ P〈0. 05）. 3 months and 6 months after operation,BCVA and CMT were obviously improved compared with preoperative,but there was no significant difference between group B and group A（ P〈0. 05）,group A and group B were better than that of group C（ P〈0. 05）. 6 months postoperatively,vision improvement rate of group A was 84. 21%,higher than that of group C（ 74. 55%） and group B（ 53. 57%）（ P〈0. 05）. Vitreous hemorrhage rate 1 month after surgery,reoperation rate and postoperative laser supplement number was lower than the other two groups,and the late bleeding,TRD,high intraocular pressure were highest in group C,but there was no significant difference between group A and group B. Conclusion Vitreous cavity injection of compaq heap combined with minimally invasive vitrectomy can be effective in the treatment of proliferative diabetic retinopathy,is more security,and more effective than simple minimally invasive vitrectomy or only injection of compaq heap.
作者
韩文龙
花雷
陆妍霞
HAN Wen-long;HUA Lei;LU Yan-xia(Eye ENT,The 455th Hospital of Chinese People＇s Liberation Army,Shanghai 200052,China;Department of Ophthalmology,Bayi Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing Jiangsu 210002,China.)
出处
《临床和实验医学杂志》
2018年第15期1644-1647,共4页
Journal of Clinical and Experimental Medicine
