围手术期血压波动与增生性糖尿病视网膜病玻璃体切除术后再出血的关系  

The relationship between perioperative blood pressure fluctuations and vitreous re-hemorrhage in proliferative diabetic retinopathy after vitrectomy

作　　者：孙哲[1] 廖昕[1] 谢春蕾[1] 高新蕊[1] 汪浩[1] 王方[1] 

机构地区：[1]同济大学附属上海市第十人民医院眼院,上海200072

出　　处：《临床眼科杂志》2015年第6期511-514,共4页Journal of Clinical Ophthalmology

摘　　要：目的探讨增生型糖尿病视网膜病变(PDR)玻璃体切除术后再出血与血糖、血脂和血压的关系。方法回顾性研究。2011年9月至2012年9月期间进行PDR玻璃体切除手术(PPV)的68例(68只眼)患者,监测围手术期中的空腹血糖值(FPG)、血脂和24 h动态血压,术后随访1年,根据是否发生再出血分为再出血组和未出血组,分析两组围手术期中监测数据的差异。结果 68例患者1年中的平均随访次数是(9.28±0.76)次。7例(7只眼,10.3%)发生术后早期再出血,平均再出血时间是(34.85±0.85)d;其中血压波动比、收缩压和收缩压波动比是术后再出血的三个重要相关危险因素(OR值分别是0.075,1.345和2.034,P<0.05)。结论 PDR患者进行PPV术后再出血的全身危险因素中,收缩压值和波动变化是一个重要指标。Objective To investigate blood glucose,blood lipid and blood pressure and their relationships to vitreous re-hemorrhage in proliferative diabetic retinopathy（ PDR） after vitrectomy. Methods Sixty-eight eyes of 68 patients with PDR who had undergone vitrectomy from Sep. 2011 to Sep. 2012 were retrospectively enrolled. These patients were divided into two groups according to the occurrence of re-hemorrhage. Clinical data that were analyzed including perioperative fasting plasma glucose（ FPG）,blood lipid and 24-hour ambulatory blood pressure during postoperative 1-year follow-up.Results Average frequency of follow-up was 9. 28 ± 0. 76 per year. The occurrence of vitreous re-hemorrhage after vitrectomy was 10. 3%（ n = 7）. In these 7 cases the average time of vitreous re-hemorrhage after vitrectomy was 34. 85 ± 0. 85 days. The fluctuation of blood pressure,systolic blood pressure and systolic blood pressure were found as the most important risk factors（ OR = 0. 075,1. 345 and 2. 034,respectively,P〈0. 05）. Conclusion This study showed that the systolic blood pressure and the fluctuation of the blood pressure were important factors for vitreous re-hemorrhage in patients with PDR after vitrectomy.

关 键 词：增生性糖尿病视网膜病 玻璃体切除术 再出血 血压 

分 类 号：R779.6[医药卫生—眼科]