CAJ | 학술논문

目的：观察分析重度增殖性糖尿病视网膜病变（ PDR）患者玻璃体切除硅油填充术后视网膜前出血程度及其转归。方法：收集2006年10月至2013年9月在浙江大学医学院附属邵逸夫医院因重度PDR需行玻璃体切除硅油填充术的76眼76例患者（其中术前使用抗血管内皮生长因子41例）的临床资料；回顾性分析患者玻璃体切除硅油填充术中出血量、术后视网膜前出血的量、出血吸收时间和术后视网膜前增殖的程度及其之间的关系。结果：患者术后视网膜前出血均发生于术后1周内，其中32例出现较薄、散在的出血；25例出现较厚、局灶性的出血；19例出现较厚、散在的出血。35例出血于术后1天停止；18例于术后2天内停止；余23例于术后2周内停止，其中包括15例1周内出现复发性出血患者。较薄出血者2周、较厚出血者5周左右出血基本吸收。15例（34.1％）较厚出血吸收后形成增殖膜。结论：重度PDR患者玻璃体切除硅油填充术后1周内均会出现不同程度出血，5周左右可以吸收。较厚较多的出血患者常并发视网膜前纤维增殖膜形成。
목적：관찰분석중도증식성당뇨병시망막병변（ PDR）환자파리체절제규유전충술후시망막전출혈정도급기전귀。방법：수집2006년10월지2013년9월재절강대학의학원부속소일부의원인중도PDR수행파리체절제규유전충술적76안76례환자（기중술전사용항혈관내피생장인자41례）적림상자료；회고성분석환자파리체절제규유전충술중출혈량、술후시망막전출혈적량、출혈흡수시간화술후시망막전증식적정도급기지간적관계。결과：환자술후시망막전출혈균발생우술후1주내，기중32례출현교박、산재적출혈；25례출현교후、국조성적출혈；19례출현교후、산재적출혈。35례출혈우술후1천정지；18례우술후2천내정지；여23례우술후2주내정지，기중포괄15례1주내출현복발성출혈환자。교박출혈자2주、교후출혈자5주좌우출혈기본흡수。15례（34.1％）교후출혈흡수후형성증식막。결론：중도PDR환자파리체절제규유전충술후1주내균회출현불동정도출혈，5주좌우가이흡수。교후교다적출혈환자상병발시망막전섬유증식막형성。
Objective:To examine the prognosis of preretinal hemorrhage following vitrectomy and silicone oil tamponade for severe proliferative diabetic retinopathy . Methods: Clinical data of 76 cases of proliferative diabetic retinopathy treated with vitrectomy and silicone oil infusion tamponade in Sir Run Run Shaw Hospital from October 2006 to September 2013 were retrospectively reviewed .Intraoperative bleeding , postoperative preretinal bleeding , blood reabsorption time , and preretinal fibrosis were assessed .Results: All preretinal hemorrhage developed within 1 week after surgery , blood was distributed in thin and scattered patterns ( 32 cases ) , thick and localized patterns ( 25 cases ) or thick and scattered patterns ( 19 cases ) . The preretinal hemorrhage was ceased in 1 day after operation in 35 cases, in 2 days after operation in 18 cases, in two weeks after operation in 23 case.Recurrent hemorrhage occurred within 1 week after operation in 15 cases.Thin blood was largely reabsorbed in about two weeks , and thick blood was largely reabsorbed in about five weeks .Fibrosis tissue was resulted in 15 cases(34.1%) with thick blood.Conclusion: Most of preretinal hemorrhage occurs within 1 week after surgery and is reabsorpted with 5 weeks in patients with proliferative diabetic retinopathy undergoing vitrectomy and silicone oil tamponade .The major complication of preretinal bleeding is the formation of preretinal fibrosis.