CAJ | 학술논문

目的观察玻璃体手术联合玻璃体腔注射贝伐单抗治疗增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的疗效.方法采用回顾性分析临床病例对照研究.选择2012年9月至2013年9月在深圳市眼科医院和梅州市梅江区西郊街道西郊社区卫生服务中心确诊的57例PDR(IV～VⅥ期)患者(59只眼)纳入研究,并按患者就诊时间顺序及病变程度分为两组,第一组为联合治疗(PPV+IVB)组;第二组为单纯玻璃体手术(PPV)组.术后观察两组患者术眼的视力、眼压和玻璃体再出血等并发症发生情况,随访3个月以上(平均4.3个月),最后收集数据并采用彭检验进行统计学分析.结果一组为28例28只眼行玻璃体手术联合玻璃体腔注射贝伐单抗,二组为29例31只眼行单纯玻璃体手术.对比两组的视力提高,PPV+IVB组有23只眼,提高率为82.1％ (23/28);PPV组有18只眼,提高率为58.1％ (18/31),两组比较差异有统计学意义(x2=4.023,P=0.045).术后玻璃体再出血,PPV+IVB组有3只眼,比例为10.7％ (3/28);PPV组有11只眼,比例为35.5％ (11/31),两组比较差异有统计学意义(x2=4.987,P=0.026).结论玻璃体手术联合玻璃体腔注射贝伐单抗治疗PDR,有利于提高患者术后视力,预防术后玻璃体再出血等并发症.
목적 관찰파리체수술연합파리체강주사패벌단항치료증식성당뇨병시망막병변(proliferative diabetic retinopathy,PDR)적료효.방법 채용회고성분석림상병례대조연구.선택2012년9월지2013년9월재심수시안과의원화매주시매강구서교가도서교사구위생복무중심학진적57례PDR(IV～VⅥ기)환자(59지안)납입연구,병안환자취진시간순서급병변정도분위량조,제일조위연합치료(PPV+IVB)조;제이조위단순파리체수술(PPV)조.술후관찰량조환자술안적시력、안압화파리체재출혈등병발증발생정황,수방3개월이상(평균4.3개월),최후수집수거병채용팽검험진행통계학분석.결과 일조위28례28지안행파리체수술연합파리체강주사패벌단항,이조위29례31지안행단순파리체수술.대비량조적시력제고,PPV+IVB조유23지안,제고솔위82.1％ (23/28);PPV조유18지안,제고솔위58.1％ (18/31),량조비교차이유통계학의의(x2=4.023,P=0.045).술후파리체재출혈,PPV+IVB조유3지안,비례위10.7％ (3/28);PPV조유11지안,비례위35.5％ (11/31),량조비교차이유통계학의의(x2=4.987,P=0.026).결론 파리체수술연합파리체강주사패벌단항치료PDR,유리우제고환자술후시력,예방술후파리체재출혈등병발증.
Objective To observe the effect of vitreous surgery combined with intravitreal injection of bevacizumab to treat proliferative diabetic retinopathy (PDR).Methods A retrospective analysis,comparative study.From September 2012 to September 2013 57 cases (59 eyes) were diagnosed PDR (Ⅳ～Ⅵ) in the study.All the patients were randomly divided into two groups.The first group underwent combined treatment (PPV+IVB) including firstly routine vitrectomy and intravitreal injection of bevacizumab (1.5mg) postoperatively.The second group underwent only vitrectomy (PPV) which was pure vitreous operation.After operation,visual acuity,intraocular pressure and complications such as vitreous hemorrhage were observed in both groups.The follow-up time was longer than 3 months (average 4.3 months).Finally the data was collected and chi square test was used for statistical analysis.Results Among them,28 patients (28 eyes) underwent vitrectomy combined with intravitreal injection of bevacizumab and 29 cases (31 eyes) underwent only vitreous operation.Comparing visual acuity increased cases in the two groups,there were 23 eyes in PPV+IVB group,the proportion were 82.1％ (23/28); there were 18 eyes in PPV group,the proportion was 58.1％ (18/ 31).After statistical analysis,x2-4.023,P 0.045,there was a statistically significant difference; Comparing recurrent vitreous hemorrhage after operation,There were 3 eyes in PPV+IVB group,the proportion was 10.7％ (3/28); There were 11 eyes in PPV group 10 eyes,the proportion was 35.5％ (11/31).After statistical analysis,between the two groups,x2=.987,P 0.026,there was a statistically significant difference.Conclusions Vitrectomy combined with intravitreal injection of bevacizumab for treating PDR is helpful to the improvement of visual acuity after surgery,the prevention of postoperative complications such as vitreous recurrent hemorrhage.