玻璃体腔注药联合微创玻璃体切除治疗糖尿病视网膜病变的临床疗效研究

目的:探讨玻璃体腔注药联合微创玻璃体切除治疗糖尿病视网膜病变的临床疗效。方法:选择2014年1月至2016年1月在我院确诊并治疗的增生性糖尿病视网膜病变患者80例,共83只患眼,随机分为A、B两组。A组共42例患眼,接受25 G玻璃体微创手术;B组共41例患眼,在A组治疗的基础上给予玻璃体腔注射康柏西普。比较两组患者的手术情况、治疗前后最佳视力的矫正(Best-corrected visual acuity,BCVA)情况、视网膜厚度以及术后1个月不良反应的发生情况。结果:B组患者的手术时间较A组显著缩短(P0.05),且术中使用电凝的患眼、术中出血以及术中发生医源性裂隙的患眼比例显著低于A组(P0.05),新生血管消失的患眼比例显著高于A组(P0.05)。B组患者术后1个月和3个月的BVCA显著高于A组(P0.05),且术后视网膜的厚度显著薄于A组(P0.05),术后发生玻璃体积血和前方出血的患眼比例显著低于A组(P0.05)。结论:玻璃体腔注射康柏西普联合25G玻璃体微创切除术治疗增生性糖尿病视网膜病变的临床疗效显著,有利于患者术后视力以及视网膜恢复。

Clinical Curative Effect of Vitreous Cavity Injection Combined with Transconjunctival Sutureless Vitrectomy on the Patients with Poliferative Diabetic Retinopathy

ABSTRACT Objective: To investigate the clinical curative effect of vitreous cavity injection combined with transconjunctival su- tureless vitrectomy on the patients with poliferative diabetic retinopathy. Methods: 80 patients with diabetic retinopathy were enrolled in our hospital from January 2014 to January 2016, in which contained 83 sicked eyes, and randomly divided into two groups. Group A (n=40, 42 sicked eyes) accepted 25G transconjunctival sutureless vitrectomy, and Group B (n=40, 41 sicked eyes) adopted intravitreal in- jection of conbercept based on patients in Group A. The operative conditions, best-corrected visual acuity (BCV) and retinal thickness were compared between two groups, and the incidence of adverse reactions within postoperative 1 month were recorded and analyzed. Results: The operation time of group B was significantly shorter than that of group A (P<0.05). The percentage of using electric coagula- tion, operative bleeding and iatrogenic fracture space in group B were significantly lower than of those group A (P<0.05). The percentage of neovascularization vanish in group B was significantly higher than that of group A (P<0.05). The BVCA of patients in group B in post- operative 1 month and 3 month were higher than those of group A(P<0.05). And the thickness of retinal in group B were significantly thinner than those of Group A(P<0.05). The incidence of vitreous hemorrhage and hyphema in group B were significantly lower than those of Group A(P<0.05). Conclusion: Vitreous cavity injection combined with transconjunctival sutureless vitrectomy improved the operative conditions and contributed to the recovery of postoperative visual acuity and retinal in the treatment of patients with poliferative diabetic retinopathy.