突发玻璃体积血妊娠糖尿病性视网膜病变的临床特点分析  

Clinical characteristics of vitreous hemorrhage in gestational diabetic retinopathy

作　　者：陈秀英[1] 单志明[2] 任凤杰[2] 王伟[2] 

机构地区：[1]秦皇岛市第一医院产科,河北省秦皇岛066000 [2]秦皇岛市第一医院眼科,河北省秦皇岛066000

出　　处：《中国基层医药》2016年第12期1787-1790,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：河北省科技计划项目（112761108）

摘　　要：目的分析因突发玻璃体积血就诊的妊娠糖尿病性视网膜病变（DR）的临床特点。方法回顾性分析13例（26只眼）妊娠期糖尿病视网膜病变患者的临床资料。双眼复方托吡咔胺散瞳，采用眼底照相机检查双眼底，B超检查玻璃体积血及玻璃体、视网膜表面情况。结果13例26只眼视力在眼前手动至0．6。突发玻璃体积血13只眼，占50．0％（13／26）。其中，Ⅰ级玻璃体积血10只眼，占76．9％（10／13）。Ⅱ、Ⅲ级玻璃体积血2只眼，占15．4％（2／13）。Ⅳ级玻璃体积血1只眼，占7．7％（1／13）。26只眼均诊断为增生早期或纤维增生期（DRIV期）。眼底照相检查，无玻璃体积血的13只眼发现大小、数量不等的视网膜新生血管。B超证实发生玻璃体积血的13只眼内均为新鲜出血，发现伴有纤维膜4只眼，占30．8％（4／13）。未发生玻璃体积血眼及时激光治疗，发生玻璃体积血眼视玻璃体积血吸收情况分期激光治疗。随访6-10个月，病情稳定。结论因突发玻璃体积血就诊的妊娠DR，均为增生早期或纤维增生期，对视功能损害较严重。妊娠DR应引起妇产科与眼科医师的足够重视，适时、合理激光治疗。防止视功能永久性损害。Objective To observe the clinical characteristics of gestational diabetic retinopathy （DR） of 13 pregnants with vitreous hemorrhage. Methods The clinical data of 26 eyes retinopathy with 13 cases of gestational diabetes were retrospectively analyzed. After bilateral eyes were mydriatic by Pyrazole MAO amine compound, ophthalmologist used fundus camera to check bilateral fundus. B ultrasonic was used to examine vitreous hemorrhage and the surfaces of vitreous and retinal. Results In 13 cases,26 eyes vision were between hand motion -O. 6. Sudden vitreous hemorrhage in 13 eyes, accounted for 50.0% （13/26）. Among them, the class Ⅰ vitreous hemorrhage in 10 eyes, 76. 9% （10/13）. Ⅱ , Ⅲgrade vitreous hemorrhage in 2 eyes,15.4% （2/13）. Level IV vitreous hemorrhage in 1 eye, accounted for 7.7% （ 1/13 ）. 26 eyes were diagnosed with stage Ⅳ（early or fiber hyperplasia period） DR. The fundus photography：the size, number of retinal neovascularization were found in 13 eyes without vitreous hemorrhage. Ultrasound confirmed that the 13 eyes vitreous hemorrhage were fresh bleeding, and found 4 eyes with fiber membrane, accounted for 30.8% （4/13）. The eyes without vitreous hemorrhage were timely treated by laser, and the eyes with vitreous hemorrhage were treated by stage laser treatment according to the condition of vitreous hemorrhage absorption. Followed up for 4 to 6 months, in. a stable condition. Conclusion Obstetrics and gynecology doctors and ophthalmologists should pay attention to pregnancy DR with vitreous hemorrhage. Because they are all early or fiber hyperplasia period. Timely and reasonable laser treatment can prevent permanent damage of visual function.

关 键 词：玻璃体出血 糖尿病视网膜病变 妊娠 

分 类 号：R714.256[医药卫生—妇产科学] R774.1[医药卫生—临床医学]