中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2012年
5期
532-536
,共5页
曹金峰%刘早霞%赵劲松%苏冠方
曹金峰%劉早霞%趙勁鬆%囌冠方
조금봉%류조하%조경송%소관방
增殖性糖尿病视网膜病变%玻璃体切割术%出血
增殖性糖尿病視網膜病變%玻璃體切割術%齣血
증식성당뇨병시망막병변%파리체절할술%출혈
Proliferative diabetic retinopathy%Vitrectomy%Hemorrhage
目的 观察玻璃体切割术治疗增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的疗效及探讨影响手术效果的相关因素.方法 选取2008年3月至2009年12月由同一术者完成玻璃体切割术治疗PDR患者102例(117只眼)的临床资料进行回顾性分析.结果 (1) PDR Ⅳ期组36只眼(85.71％),PDR Ⅴ期组27只眼(69.23％),PDR Ⅵ期组19只眼(52.78％)术后视力提高.(2)在PDR Ⅳ期组中,玻璃体积血时间小于2个月组术后视力改善率高于2～3个月组(x2=4.621,P=0.032); 2～3个月组和大于3个月组的差异没有统计学意义(x2=0,P=1.000).(3)一次术后总的视网膜解剖在(复)位数为112只眼(95.73％),PDR Ⅳ期组41只眼(97.62％),PDR Ⅴ期组38只眼(97.44％),PDR Ⅵ期组33只眼(91.67％).(4)玻璃体再出血情况:术后保留灌注液组9只眼(17.31％)、C3F8填充组4只眼(13.33％)、硅油填充组6只眼(17.14％)发生玻璃体再出血,差异无统计学意义( x2=0.251,P=0.882).术前行PRP组3只眼(6.52％),未行PRP组16只眼(22.54％)发生玻璃体再出血,差异有统计学意义(x2=4.151,P=0.042).结论 玻璃体切割术能有效地改善增殖性糖尿病视网膜病变患者的视力；掌握恰当的手术时机对预后十分重要.
目的 觀察玻璃體切割術治療增殖性糖尿病視網膜病變(proliferative diabetic retinopathy,PDR)的療效及探討影響手術效果的相關因素.方法 選取2008年3月至2009年12月由同一術者完成玻璃體切割術治療PDR患者102例(117隻眼)的臨床資料進行迴顧性分析.結果 (1) PDR Ⅳ期組36隻眼(85.71％),PDR Ⅴ期組27隻眼(69.23％),PDR Ⅵ期組19隻眼(52.78％)術後視力提高.(2)在PDR Ⅳ期組中,玻璃體積血時間小于2箇月組術後視力改善率高于2～3箇月組(x2=4.621,P=0.032); 2～3箇月組和大于3箇月組的差異沒有統計學意義(x2=0,P=1.000).(3)一次術後總的視網膜解剖在(複)位數為112隻眼(95.73％),PDR Ⅳ期組41隻眼(97.62％),PDR Ⅴ期組38隻眼(97.44％),PDR Ⅵ期組33隻眼(91.67％).(4)玻璃體再齣血情況:術後保留灌註液組9隻眼(17.31％)、C3F8填充組4隻眼(13.33％)、硅油填充組6隻眼(17.14％)髮生玻璃體再齣血,差異無統計學意義( x2=0.251,P=0.882).術前行PRP組3隻眼(6.52％),未行PRP組16隻眼(22.54％)髮生玻璃體再齣血,差異有統計學意義(x2=4.151,P=0.042).結論 玻璃體切割術能有效地改善增殖性糖尿病視網膜病變患者的視力；掌握恰噹的手術時機對預後十分重要.
목적 관찰파리체절할술치료증식성당뇨병시망막병변(proliferative diabetic retinopathy,PDR)적료효급탐토영향수술효과적상관인소.방법 선취2008년3월지2009년12월유동일술자완성파리체절할술치료PDR환자102례(117지안)적림상자료진행회고성분석.결과 (1) PDR Ⅳ기조36지안(85.71％),PDR Ⅴ기조27지안(69.23％),PDR Ⅵ기조19지안(52.78％)술후시력제고.(2)재PDR Ⅳ기조중,파리체적혈시간소우2개월조술후시력개선솔고우2～3개월조(x2=4.621,P=0.032); 2～3개월조화대우3개월조적차이몰유통계학의의(x2=0,P=1.000).(3)일차술후총적시망막해부재(복)위수위112지안(95.73％),PDR Ⅳ기조41지안(97.62％),PDR Ⅴ기조38지안(97.44％),PDR Ⅵ기조33지안(91.67％).(4)파리체재출혈정황:술후보류관주액조9지안(17.31％)、C3F8전충조4지안(13.33％)、규유전충조6지안(17.14％)발생파리체재출혈,차이무통계학의의( x2=0.251,P=0.882).술전행PRP조3지안(6.52％),미행PRP조16지안(22.54％)발생파리체재출혈,차이유통계학의의(x2=4.151,P=0.042).결론 파리체절할술능유효지개선증식성당뇨병시망막병변환자적시력；장악흡당적수술시궤대예후십분중요.
Objective To observe the surgical effect of vitrectomy for treating PDR and investigate the factors which influence the surgery. Methods The clinical data of 117 eyes (102 patients)who underwent vitrectomy by the same surgeon in our hospital were retrospectively studied from March,2008 to December,2009. Results Thirty-six eyes (85.71％) in PDR Ⅳ group,27 eyes (69.23％) in PDR Ⅴ group and 19 eyes (52.78％) in PDR Ⅵ group gained improvements in visual acuity after surgery.According to the duration of vitreous hemorrhage in PDR Ⅳ group,the postoperative visual acuity improvement rate of less than 2 months group was higher than that of 2-3months group (x2=4.621,P =0.032).There was no significant difference between 2-3 months group and more than 3 months group (x2=0,P =1.000).The total eyes with anatomically retinal attachment after one surgery were 112 (95.73％),including 41 eyes (97.62％) in PDR Ⅳ group,38 eyes (97.44％) in PDR Ⅴ group and 33 eyes (91.67％) in PDR Ⅵ group.Recurrent vitreous hemorrhage,The 9 eyes (17.31％) in irrigation solution group,4 eyes (13.33％) in C3F8 group and 6 eyes (17.14％) in silicon oil group presented recurrent vitreous hemorrhage.After vitrectomy,the distinction had no statistical significance (x2=0.251,P =0.882).The 3 eyes (6.52％) in preoperative PRP group and 16 eyes (22.54％) in non-preoperative PRP group encountered postoperative vitreous hemorrhage respectively,the distinction had statistical significance (x2=4.151,P=0.042). Conclusions The visual acuities of PDR patients can be well improved by pars plana vitrectomy.To master the appro priate opportunity of surgery is crucial for good prognosis.
