标题:玻璃体切除术联合雷珠单抗玻璃体注射治疗增殖性糖尿病视网膜病变的临床研究
作者:张妍春,任秀瑜,康紫薇,雷春灵 (西安市第四医院眼科陕西省眼科医院眼科;西安市眼底病研究所;西安交通大学附属广仁医院眼科,陕西 西安 710004)
卷次:
2018年29卷23期
【摘要】 目的 探讨玻璃体切除术(PPV)联合雷珠单抗玻璃体注射治疗增殖性糖尿病视网膜病变(PDR)的临床疗效。方法 选择2014年1月至2017年12月西安市第四医院眼科收治的68例PDR患者为研究对象,按照随机数表法分为观察组和对照组,每组34例,观察组给予PPV联合雷珠单抗玻璃体注射治疗,对照组单纯给予PPV治疗,比较两组患者术后视力改善情况、手术时间、眼内压、黄斑中心凹视网膜和并发症情况。结果 观察组患者的术后视力改善率为 70.6%,明显高于对照组的 41.2%,差异具有统计学意义(P<0.05);观察组患者手术时间为(55.7±11.6) min,明显短于对照组的(92.4±13.5) min,黄斑中心凹视网膜厚度为(289.3±20.1) μm,明显低于对照组(331.5±22.4) μm,差异均有统计学意义(P<0.05);观察组和对照组患者术后眼压[(17.4±3.3) mmHg vs (18.7±3.5) mmHg]比较差异无统计学意义(P>0.05);并发症主要为无菌性眼炎、术后再出血、术后感染和再增殖,观察组患者术后并发症的发生率为 17.6% (6/34),明显低于对照组的 55.9% (19/34),差异有统计学意义(P<0.05)。结论 PPV联合雷珠单抗玻璃体注射治疗PDR可以有效改善患者视力,减少术后并发症发生率,临床疗效显著,值得推广应用。
【关键词】 增殖性糖尿病视网膜病变;雷珠单抗;玻璃体切除术;玻璃体腔注射
【中图分类号】 R587.2 【文献标识码】 A 【文章编号】 1003—6350(2018)23—3296—04
Effect of pars plana vitrectomy combined with intravitreal injection of lucentis in the treatment of proliferativediabetic retinopathy.
ZHANG Yan-chun 1, REN Xiu-yu, KANG Zi-wei, LEI Chun-ling. Department of Ophthalmology,Xi'an Fourth Hospital (Department of Ophthalmology, Shaanxi Ophthalmological Hospital; Xi'an Institute of FundusDiseases; Guangren Hospital Affiliated to Xi'an Jiaotong University), Xi'an 710004, Shaanxi, CHINA
【Abstract】 Objective To explore the effect of pars plana vitrectomy combined with intravitreal injection of lu-centis in the treatment of proliferative diabetic retinopathy (PDR). Methods A total of 68 patients with proliferative dia-betic retinopathy (PDR) from Department of Ophthalmology, Xi'an Fourth Hospital from January 2014 to December2017 were randomly divided into the observation group (n=34) and the control group (n=34) according to random num-ber table. Patients in the observation group were treated with pars plana vitrectomy combined with intravitreal injec-tion of lucentis, while those in the control group were treated with pars plana vitrectomy only. Then the visual acuityimprovement, operation time, intraocular pressure, macular foveal retinal thickness, and complications were comparedbetween the two groups. Results The improvement rate of visual acuity was 70.6% in observation group, which wassignificantly higher than 41.2% in the control group (P<0.05). The operation time and macular fovea retinal thicknesswere (55.7±11.6) min and (289.3±20.1) μm in the observation group, versus (92.4±13.5) min and (331.5±22.4) μm in thecontrol group (P<0.05). There was no statistically significant difference between the two group in intraocular pressure:(17.4±3.3) mmHg vs (18.7±3.5) mmHg, P>0.05. The main complications included aseptic endophthalmitis, postopera-tive rebleeding, postoperative infection, and reproliferation. The incidence of complications in the observation group wassignificantly lower than that of the control group: 17.6% (6/34) vs 55.9% (19/34), P<0.05. Conclusion Pars plana vit-rectomy combined with intravitreal injection of lucentis has significant effect in the treatment of PDR, which can signifi-cantly improve the vision of patients and results in less postoperative complications.
【Key words】 Proliferative diabetic retinopathy; Lucentis; Pars plana vitrectomy; Intravitreal injection·论 著·doi:10.3969/j.issn.1003-6350.2018.23.013基金项目:陕西省社会发展攻关计划(编号:2013K12-09-08);陕西省自然科学基础研究计划面上项目(编号:2015JM8408);陕西省中医管理局中医药科研课题面上项目(编号:JCMS063);西安市“科技+”行动计划重大研究项目[编号:201805104YX12SF38(3)]
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