玻璃体切割手术联合全视网膜光凝术治疗糖尿病视网膜病变临床疗效观察  

Clinical effect of pars plana vitrectomy combined with panretinal photocoagulation in treatment of diabetic retinopathy

作　　者：白淑玮[1] 毕春潮[1] 邵娟[1] 周卓琳[1] 许治国[1] BAI Shuwei;BI Chunchao;SHAO Juan(Xi’an No.4 Hospital,Xi’an 710004)

机构地区：[1]西安市第四医院,西安710004

出　　处：《陕西医学杂志》2020年第12期1569-1572,共4页Shaanxi Medical Journal

基　　金：国家自然科学基金资助项目(81302189)。

摘　　要：目的:观察玻璃体切割手术(PPV)联合全视网膜光凝术(PRP)对糖尿病视网膜病变(DR)的临床疗效。方法:选取29例DR患者(29眼)作为研究对象,根据手术方法的不同分为PPV组(14例,14眼)和PRP组(15例,15眼)。PPV组给予PPV联合PRP治疗,PRP组给予单纯PRP治疗。随访2年后,比较两组患者术前与随访2年后最佳矫正视力(BCVA)以及糖尿病黄斑水肿(DME)、视盘新生血管(NVD)和视网膜新生血管(NVE)出现情况。结果:经过2年随访,PPV组患者BCVA优于PRP组,差异具有统计学意义(P<0.05)。PPV组视网膜前出血/玻璃体出血发生率低于PRP组,差异具有统计学意义(P=0.042)。PPV组随访2年后BCVA较术前轻度提高,但差异无统计学意义(P=0.102)。PRP组随访2年后BCVA较术前显著下降,差异具有统计学意义(P=0.006)。结论:对于NPDR和早期PDR,PPV联合PRP治疗可能维持患者现有视力,甚至提高患者视力,可以作为DR治疗的一种治疗选择。Objective:To investigate the clinical effect of pars plana vitrectomy(PPV)combined with panretinal photocoagulation(PRP)in the treatment of diabetic retinopathy(DR).Methods:29 patients(29 eyes)with DR were selected and divided into PPV group(14 cases,14 eyes)and PRP group(15 cases,15 eyes)according to different surgical methods.PPV group was treated with PPV combined with PRP,and PRP group was treated with PRP alone.The best corrected visual acuity(BCVA),diabetic macular edema(DME),neovascularization of the disk(NVD)and neovascularization elsewhere(NVE)before surgery and after 2 years of follow-up were compared between the two groups.Results:After 2 years of follow-up,the BCVA in PPV group was better than that in PRP group(P<0.05).The incidence of preretinal hemorrhage/vitreous hemorrhage in PPV group was lower than that in PRP group(P=0.042).The BCVA in PPV group was increased slightly after 2 years of follow-up,but the difference was not statistically significant(P=0.102).The BCVA in PRP group was decreased significantly after 2 years of follow-up(P=0.006).Conclusion:For severe NPDR and early PDR,PPV combined with PRP may maintain the existing visual acuity of patients,and even improve their visual acuity,which can be used as a treatment option for DR.

关 键 词：玻璃体切割手术 糖尿病视网膜病变 视盘新生血管 视网膜新生血管 糖尿病黄斑水肿 全视网膜光凝术 

分 类 号：R587.2[医药卫生—内分泌]