玻璃体内注射雷珠单抗联合玻璃体切割术治疗增生型糖尿病视网膜病变的疗效观察  

Intravitreal injection of ranibizumab combined with vitrectomy for proliferative diabetic retinopathy

作　　者：冯希敏[1] 祁颖[2] 张凤妍[2] 赵庆新[1] 秦云凤[1] 

机构地区：[1]新乡市中心医院眼科,河南省新乡市453000 [2]郑州大学第一附属医院眼科,河南省郑州市450052

出　　处：《眼科新进展》2016年第11期1079-1081,共3页Recent Advances in Ophthalmology

摘　　要：目的评价玻璃体内注射雷珠单抗联合玻璃体切割术治疗增生型糖尿病视网膜病变（proliferative diabetic retinopathy，PDR）的临床疗效。方法回顾性分析郑州大学第一附属医院2015年7月至2016年1月就诊的PDR患者共45例（57眼）。根据手术方式不同分为对照组和观察组，单纯行玻璃体切割术者为对照组，共24例31眼，年龄（51．27±17．15）岁；玻璃体切割术术前3～5d行玻璃体内注射雷珠单抗者为观察组，共21例26眼，年龄（50．34±13．94）岁。随访时间为3～6个月。主要比较两组的最佳矫正视力（best corrected visual acuity，BCVA）、黄斑中心凹厚度、手术时间和并发症。结果两组术前BCVA比较差异无统计学意义（x^2=2．511，P〉0．05），两组术后BCVA比较，观察组明显高于对照组，差异有统计学意义（x^2=11．834，P〈0．05）。两组术后BCVA与术前比较，均有不同程度提升，x^2值分别为10．927、18．970，差异均有统计学意义（均为P〈0．05）。术后7d观察组黄斑中心凹厚度明显较对照组薄，差异有统计学意义（t=7．034P〈0．05），术后3个月两组黄斑中心凹厚度比较，差异无统计学意义（t=0．371，P〉0．05）。两组术后3个月黄斑中心凹厚度与7d时比较均明显变薄（t值分别为8．706、5．473），差异均有统计学意义（均为P〈0．05）。两组手术时间比较，观察组手术时间为（42．75±8．90）min，明显短于对照组的（71．58±14．78）min，差异有统计学意义（t=9．075，P〈0．05）。两组术中发生医源性裂孔的眼数比较，差异无统计学意义（x^2=0．934，P〉0．05）。对照组术中应用电凝止血次数明显多于观察组，差异有统计学意义（x^2=24．097，P〈0．05）；对照组术中填充硅油的眼数明显高于观察组，差异有统计学意义（x^2=8．148，P〈0．05）；两组术后出血的眼数比较，差异无统计学意义Objective To evaluate the clinical efficacy of intravitreal ranibizumab injection combined with vitrectomy for proliferative diabetic retinopathy （PDR）. Methods 45 cases （57 eyes） with PDRin our hospital from July2015 to January2016 were chosen. The patients were randomly divided into two groups according to the different treatments：the patients in research group （Male： 10 case, 13 eyes;Female： ll cases, 13 eyes） were treated with 0.5 mg ranibizumab intravitreal injection 3 - 5 days before vitrectomy while the patients in control group （ Male： 11 case, 14 eyes; Female ： 13 cases, 17 eyes） were treated only by vitrectomy. The best corrected visual acuity（BCVA） ,macular thickness, operation time and complications were observed. Results There was no statistical difference in preoperative BCVA between two groups （x^2 = 2.511 ,P 〉 0.05 ）. Compared with control group, the postoperative BCVA of research group was significantly better （x^2= 11. 834 ,P 〈 0.05 ）. There were statistical differences in BCVA before and after operation （x^2 = 10. 927,18. 970 ; all P 〈 0.05 ）. At postoperative 7 days ,the macular thickness in the research group was thinner than that in the control group （ t = 7. 034,P〈0.05） ,but there was no statistical difference at postoperative 3 months （ t = 0. 371 ,P 〈 0.05 ）. The macular thickness in two group at postoperative 3 months were thinner than that at postoperative 7 days （ t = 8.705,5. 473 ; all P 〈 0.05 ）. The operation time in the research group was （42.75 ± 8.90） minutes,which was significantly shorter than （71.58 ±14.78） nfinutes in the control group （ t = 9. 075, P 〈 0.05 ）. There was no statistical difference in the incidence of iatrogenlc retinal breaks between two groups （x^2 = 0. 934, P 〉 0.05 ）, The electric coagulation times in the control group was more than that in the research group （x^2= 24.097 ,P 〈 0.05 ）. The filler of silicon oil decreased obviously in research group （x^2= 19. 516 ,

关 键 词：糖尿病视网膜病变 雷珠单抗 玻璃体内注射 玻璃体切割术 

分 类 号：R774.1[医药卫生—眼科]