不同分期增生性糖尿病视网膜病变玻璃体手术的疗效观察  

Clinical efficacy of vitrectomy for proliferative diabetic retinopathy at different stages

作　　者：范传峰[1] 王玉[1] 舒相汶[1] 张华[1] 盛艳娟[1] 吴昌龙[1] 

机构地区：[1]山东省济南市第二人民医院眼科,250001

出　　处：《眼科新进展》2010年第1期47-49,共3页Recent Advances in Ophthalmology

基　　金：济南科学技术局科技计划基金资助(编号:061035)~~

摘　　要：目的评估不同分期增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)行玻璃体切割术的治疗效果,观察术后的视力和并发症情况,探讨其预后的差别。方法我院因PDR行玻璃体手术的患者300例(384眼),按PDR的分期将其分为Ⅳ期、Ⅴ期和Ⅵ期3组,并将Ⅳ期患者根据行玻璃体手术的时间分为早期治疗组和中晚期治疗组;比较各组间的视力预后及并发症发生情况。结果384眼中,随访时视力较术前提高者有271眼(70.6%),其中Ⅳ-Ⅴ期171眼(85.5%),Ⅵ期100眼(54.3%),二者差异具有统计学意义(χ2=120.44,P<0.05);Ⅳ期的早、中晚期治疗组术后视力>0.05患眼所占的比例分别为82.8%和64.6%,差异具有统计学意义(χ2=4.861,P<0.05)。98眼发生玻璃体积血或视网膜脱离,其中Ⅳ-Ⅴ其39眼,Ⅵ期59眼,二者比较差异有统计学意义(P<0.05)。结论玻璃体手术能有效地控制PDR的病情,及时有效的玻璃体手术是挽救严重PDR患者有用视功能的关键。Objective To investigate the clinical efficacy of vitrectomy for proliferative diabetic retinopathy（PDR） at different stages,and to explore the differences of prognosis with comparing the postoperative visual acuity and complications.Methods A total of 300 PDR patients （384 eyes） were treated with vitrectomy in our hospital,and divided into 3 groups,patients at stage Ⅳ,patients at stageⅤ and patients at stage Ⅵ,according to different stages of PDR.Patients at stage Ⅳ were subdivided into early treatment group and middle and late treatment group according to the time of vitrectomy.The prognosis of visual acuity and complications were compared among groups.Results At following up time,visual acuity of 271 eyes（70.6%） improved in a total of 384 eyes compared with those preoperatively,among which were 171 eyes（85.5%） at stage Ⅳ to stage Ⅴand 100 eyes（54.3%） at stage Ⅵ,there was statistical difference（χ^2=120.44,P〈0.05）.Postoperative visual acuity more than 0.05 were 82.8% in early treatment group and 64.6% in middle and late treatment group for patients at stage Ⅳ（χ^2=4.861,P〈0.05）.There were 98 eyes with vitreous hemorrhage or retinal detachment,39 eyes at stage Ⅳ to stage Ⅴ,59 eyes at stage Ⅵ（P〈0.05）.Conclusions Vitrectomy can effectively control the pathological changes of PDR.Timely and effective vitrectomy is the key point for improving visual function of patients with serious PDR.

关 键 词：增生性糖尿病视网膜病变 玻璃体切割术 玻璃体积血 视力 

分 类 号：R774.1[医药卫生—眼科]