玻璃体积血1263例病因分析  

Analysis of the causes of vitreous hemorrhage in 1263 cases

作　　者：罗文彬[1] 游志鹏[1] 

机构地区：[1]南昌大学第二附属医院眼科,江西南昌330006

出　　处：《中国现代医学杂志》2014年第4期66-71,共6页China Journal of Modern Medicine

摘　　要：目的研究玻璃体积血的原因及构成特点。方法对以玻璃体积血为首诊的1 263例1 305眼患者的病历资料进行回顾性的原因分析。结果在该研究中,增殖型糖尿病性视网膜病变（proliferative diabetic retinopathy,PDR）致玻璃体积血者最多,为385例（30.48%）;其次为眼外伤376例（29.77%）,再次为视网膜静脉阻塞（retinal vein occlusion,RVO）168例（13.30%）;视网膜裂孔和孔源性视网膜脱离133例（10.53%）,视网膜静脉周围炎65例（5.15%）,渗出性老年黄斑变性41例（3.25%）,视网膜大动脉瘤41例（3.25%）和特发性息肉状脉络膜血管病变21例（1.67%）。各年龄组病因构成差异存在显著性（χ2=419.808,P〈0.01）。〈45岁的青年组中,眼外伤导致玻璃体积血的最多,为286例（63.13%）,其次为PDR 58例（12.80%）,视网膜静脉周围炎50例（11.04%）,再次为视网膜裂孔和孔源性视网膜脱离34例（7.51%）。45~59岁中年组,PDR致玻璃体积血的最多,为178例（44.61%）,其次为RVO 71例（17.79%）,眼外伤65例（16.29%）,再次为视网膜裂孔和孔源性视网膜脱离53例（13.28%）。≥60岁老年组,PDR致玻璃体积血的最多,为149例（36.25%）,其次为RVO 88例（21.41%）,视网膜裂孔和孔源性视网膜脱离46例（11.19%）,再次为渗出型老年性黄斑变性39例（9.49%）及视网膜大动脉瘤38例（9.25%）。男女病因构成差异存在显著性（χ2=61.436,P〈0.01）。721例男性患者的主要致病原因依次为眼外伤、PDR,RVO,视网膜裂孔和孔源性视网膜脱离,视网膜静脉周围炎,分别占总男性患者人数的38.56%、25.80%、11.37%、9.71%和6.24%。542例女性患者中,PDR,眼外伤、RVO,孔源性视网膜脱离为导致玻璃体积血的主要原因,分别占36.71%、18.09%、15.88%和11.62%。结论增殖型糖尿病性视网膜病变,眼外伤,视网膜静脉阻塞及视网膜裂孔和孔源性视网膜脱离是玻璃体积血的主要原因。【Objective】 To investigate the cause of vitreous hemorrhage and constitutional characteristics. 【Methods】The clinical data of 1305 eyes of 1263 patients with vitreous hemorrhage were studied for the causal analysis from January 2005 to May 2012. 【Results】Of all the causes, proliferative diabetic retinopathy（PDR） was the principal causes（385 patients, 30.48%）, the second was ocular trauma（376 patients, 29.77%）, the third was retinal vein occlusion（RVO, 168 patients, 13.30%）, followed by rhegmatogenous retinal detachment and retinal breaks（133 patients, 10.53%）, Eale＇s disease（65 patients, 5.15%）, exudative age related macular degeneration（41 patients, 3.25%）, retinal arterial macroaneurysm（41patients, 30.25%） and polypoidal choroidal vasculopathy（21patients, 1.67%）. 453 cases in youth group（45 years old）, the principal cause was ocular trauma（286 patients, 63.13%）, the second was PDR（58 patients, 12.08%）, the third was Eale＇s disease（50 patients, 11.04%）, the forth was rhegmatogenous retinal detachment and retinal breaks（34 patients, 7.51%）; 399 cases in middle-aged group（45~59 years old）, PDR was the principal cause（178 patients, 44.61）, the second was RVO（71 patients, 17.79%）, the third was Ocular trauma（65 patients, 16.29%）, followed by rhegmatogenous retinal detachment and retinal breaks（53 patients, 13.28%）; 411 cases in old group（≥60 years old）, the principal cause was PDR（149 patients, 36.25%）, the second was RVO（88 patients, 21.41%）, the third was rhegmatogenous retinal detachment and retinal breaks（46 patients, 11.19%）, followed by exudative age related macular degeneration（39 patients, 9.49%） and tetinal artetial macroaneurysm（38 patients, 9.25%）. There was statistically significant difference among them（χ2=419.808, P 0.01）. The major causes of 721 males were Ocular trauma, PDR, RVO, rhegmatogenous retinal detachment and retinal breaks and Eale＇s disease, accounted for 38.56%, 25.8

关 键 词：玻璃体积血 原因 年龄 性别 治疗 

分 类 号：R776.4[医药卫生—眼科]