玻璃体腔注射贝伐单抗在增殖性糖尿病视网膜病变玻璃体手术中的应用  

Study on Application of Intravitreal Injection of Bevacizumab in Vitrectomy for Proliferative Diabetic Retinopathy

作　　者：李志强 钟敬雯 蔡展谋 田汝银[2] 张国明[2] 曾键[2] 张福燕[3] 

机构地区：[1]梅江区西郊街道西郊社区卫生服务中心,广东梅州514031 [2]暨南大学第二临床医学院深圳市眼科医院,广东深圳518040 [3]贵州医科大学附院眼科,贵州贵阳550004

出　　处：《贵阳医学院学报》2015年第9期959-961,965,共4页Journal of Guiyang Medical College

基　　金：梅州市科技局项目(2013B71);贵州省科技攻关项目(黔科合S字2011-3109);贵州省科技基金(黔科合J字2008-2160)

摘　　要：目的：研究玻璃体腔注射贝伐单抗（IVB）在增殖性糖尿病视网膜病变（PDR）微创手术的应用时机和效果。方法：选择60例PDR（IV、V期）患者（60只眼）随机分为术前IVB组及术毕IVB组,分别于玻璃体微创手术前1~2周及手术结束时行玻璃体腔IVB注射,观察术后两组患者术眼的视力及玻璃体再出血等并发症。结果：术前IVB组视力提高17只眼（17/30,56.7%）,术毕IVB组视力提高25只眼（25/30,83.3%）,两组比较差异有统计学意义（χ2=5.302,P〈0.05）;术前IVB组术后玻璃体再出血有11只眼（11/30,36.7%）;术毕IVB组术后玻璃体再出血有3只眼（3/30,10.0%）,两组比较差异有统计学意义（χ2=4.789,P〈0.05）。结论：微创玻璃体手术术毕IVB比术前IVB治疗更有利于提高PDR患者术后视力,降低术后玻璃体再出血等并发症发生率。Objective： To investigate the time and effect of intravitreal injection of bevacizumab （IVB） in minimally invasive vitrectomy for proliferative diabetic retinopathy （PDR）. Methods： Sixty patients diagnosed as stage IV and V of PDR were randomly divided into two groups ： preoperative IVB group and postoperative IVB group, intravitreal injection of bevacizumab 1 -2 weeks before and after difference （X2 = 5. 302, P 〈 0.05 ）. There were 11 eyes showed vitreous hemorrhage recurrence in the preoperative IVB group, the proportion was 36.7 % （11/30） ; there were 3 eyes who had vitreous hem- orrhage recurrence in postoperative IVB group, the proportion was 10.0% （3/30） ; there was a statisti- cally significant difference （X2 = 4. 789, P 〈0. 05 ）. Conclusions： Comparing to preoperative IVB, minimally invasive vitreetomy combined with postoperative IVB for treating PDR is helpful to the improvement of visual acuity after surgery, the prevention of postoperative complications such as vitreous recurrent hemorrhage is more effective.

关 键 词：贝伐单抗 糖尿病视网膜病变 眼外科手术 玻璃体 手术后并发症 

分 类 号：R587.1[医药卫生—内分泌] R774.1[医药卫生—内科学]