两种手术方式治疗早产儿视网膜病变的疗效比较  

The different clinical effects of intravitreal ranibizumab and laser photo coagulation treatment to retinopathy of prematurity

作　　者：杨波[1] 金海鹰[2] 

机构地区：[1]新疆维吾尔自治区人民医院眼科,乌鲁木齐830000 [2]上海交通大学附属新华医院眼科,200000

出　　处：《临床眼科杂志》2015年第4期315-318,共4页Journal of Clinical Ophthalmology

摘　　要：目的观察比较玻璃体腔注射雷珠单克隆抗体法(IVR)及激光光凝法治疗早产儿视网膜病变(ROP)的疗效。方法选取ROP患儿50例(98只眼)患者,阈值期病变37例(72只眼),阈值前病变1型8例(16只眼),急进性后部型(AP-ROP)5例(10只眼)。对AP-ROP、Ⅰ区病变或者身体素质较差的患儿采取IVR治疗,共计41例(80只眼),作为IVR组。而对视网膜Ⅱ区3期纤维增生的患儿采取激光光凝治疗,共计9例(18只眼),作为激光光凝组。比较分析AP-ROP、阈值期病变及阈值前病变1型患儿的首次治愈率。结果在IVR组的18只眼中7只眼首次接受治疗便成功治愈,首次治愈率为38.89%;11只眼病情未得到控制,占61.11%,对其进行再次的IVR治疗或者激光光凝治疗后病情稳定。在激光光凝组中的80只眼中77只眼首次接受治疗便成功治愈,首次治愈率为96.25%;3只眼病情未得到控制,占3.75%,对其进行玻璃体切割处理后病情稳定。比较IVR组及激光光凝组的首次治愈率,差异明显,差异具有统计学意义(χ2=39.484,P<0.001)。AP-ROP、阈值期病变及阈值前病变1型的患儿首次治愈率为50.00%、97.22%及56.25%,比较此三个首次治愈率,差异明显,差异具有统计学意义(χ2=29.547,P<0.001)。结论对AP-ROP、Ⅰ区病变或者身体素质较差的患儿采取IVR治疗可取得较好的疗效,而对视网膜Ⅱ区3期纤维增生的患儿采取激光光凝治疗可取得较好的疗效。Objective To explore the different clinical effects of intravitreal ranibizumab and laser photo coagula-tion treatment to retinopathy of prematurity.Methods 50 ROP infants （98 eyes） were selected as object of study, inclu-ding aggressive posterior ROP （AP-ROP,5 infants,10 eyes）,threshold ROP （37 infants,72 eyes） and type 1 pre-threshold ROP （8 infants,16 eyes）.And the patients were divided into intravitreal ranibizumab （IVR） group （9 infants,18 eyes） and laser photocoagulation （LP） treatment group （41 infants,80 eyes）.The difference between the two groups＆#39;birth weight, infant gestational age, corrected gestational age when first treatment and cure rate after the first treatment were com-pared and analyzed.As well as the three disease types （ AP-ROP, threshold and type 1 pre-threshold） .Results There wasn＇t a difference of birth weight and gestational age between IVR group and LP group （ t =0.302, P =0.763;t =-0.208, P =0.836）.While there was a significant difference of the corrected gestational age when first treatment between IVR group and LP group （ t =-4.714, P 〈0.001）.Among the 18 eyes of the IVR group,7 eyes （38.89%） were cured after the first treatment and 11 eyes （61.11%） got out of the control but were controlled after repeated IVR or laser photo-coagulation.Among the 80 eyes of the LP group, 77 eyes （ 96.25%） were cured after the first treatment and 3 eyes （3.75%） got out of the control but were controlled after vitrectomy.There wasn＇t a significant difference of birth weight and gestational age between AP-ROP, threshold and type 1 pre-threshold infants .And there wasn＇t a significant difference of the corrected gestational age when first treatment between threshold and type 1 pre-threshold infants （ t =1.785, P =0.078） .While there was a significant difference of the corrected gestational age when first treatment between AP-ROP and type 1 pre-threshold infants （ t =4.148, P 〈0.001） and between AP-ROP and threshold lesion

关 键 词：激光光凝治疗 玻璃体腔注射雷珠单克隆抗体 早产儿视网膜病变 

分 类 号：R779.6[医药卫生—眼科]