雷珠单抗辅助玻璃体切除术治疗糖尿病性牵引性视网膜脱离  

Ranibizumab assisted with vitrectomy for the treatment of diabetic tractional retinal detachment

作　　者：严晓腾 顾操 陆培荣[2] Yan Xiaoteng;Gu Cao;Lu Peirong(Department of Ophthalmology,Huai’an Second People’s Hospital,The Affiliated Huai’an Hospital of Xuzhou Medical University,Jiangsu 223002,China;Department of Ophthalmology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Department of Ophthalmology,Changhai Hospital Affiliated to Naval Military Medical University,Shanghai 200433,China)

机构地区：[1]淮安市第二人民医院眼科,徐州医科大学附属淮安医院,江苏223002 [2]苏州大学附属第一医院眼科,江苏215006 [3]海军军医大学附属长海医院眼科,上海200433

出　　处：《中华眼外伤职业眼病杂志》2021年第3期221-225,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：淮安市科技计划项目(HAB201935)。

摘　　要：目的评价雷珠单抗辅助玻璃体切除术治疗糖尿病性牵引性视网膜脱离的临床疗效。方法回顾性研究2017年1月至2019年10月淮安市第二人民医院收治糖尿病性牵拉性视网膜脱离42例(42眼)的临床资料。患者分为两组:A组,雷珠单抗辅助玻璃体切除组,19例(19眼);B组,单纯玻璃体切除组,23例(23眼)。术后随访3个月,比较两组术后视力、手术时间及并发症。结果术后3个月A组视网膜复位成功18例(94.7%,18/19);B组视网膜复位成功21例(91.3%,21/23),两组比较差异无统计学意义(χ^(2)=0.185,P=0.671)。两组视力(BCVA,logMAR)均较术前提高,但两组之间差异无统计学意义(t=1.100,P=0.278)。A组3例(15.8%,3/19)因术中出血行电凝,少于B组的14例(60.8%,14/23)(χ^(2)=8.776,P=0.030)。A组术中硅油填充10例(52.6%,10/19),少于B组术中的19例(82.6%,19/23)(χ^(2)=4.375,P=0.036)。结论雷珠单抗辅助玻璃体切除治疗糖尿病性牵引性视网膜脱离,可以有效改善术后视力,减少术中出血,降低硅油填充率。Objective To evaluate the clinical efficacy of intravitreal ranibizumab injection assisted with vitrectomy for the treatment of diabetic tractional retinal detachment(TRD).Methods This was a retrospective study.The clinical data of 42 eyes of 42 patients with diabetic tractional retinal detachment from Jan.2017 to Oct.2019 in the Huai’an Second People’s Hospital were divided into two groups.Group A,19 eyes of 19 cases,received ranibizumab assisted with vitrectomy.Group B,23 eyes of 23 cases,received vitrectomy.The postoperative vision,operation time and complications of the two groups were compared.The follow-up time was 3 months.Results At 3 months after operation,18 cases(94.7%,18/19)in the group A were successful in retinal reattachment,and 21 cases(91.3%,21/23)in the group B.The difference was not statistically significant between the two groups(χ^(2)=0.185,P=0.671).BCVA at 3 months postoperatively of the two groups was ameliorated.The difference was not statistically significant between the two groups(t=1.100,P=0.278).Electrocoagulation was performed in 3 cases(15.8%,3/19)with intraoperative bleeding in the group A,which was less than that in(60.8%,14/23)group B 14 cases(χ^(2)=8.776,P=0.030).Ten cases(52.6%,10/19)received silicone oil tamponade in the group A,which was less than that in 19 cases(82.6%,19/23)in group B(χ^(2)=4.375,P=0.036).Conclusion Ranibizumab assisted with vitrectomy for the treatment of diabetic traction retinal detachment can effectively improve postoperative vision,reduce intraoperative hemorrhage and silicone oil tamponade rate.

关 键 词：雷珠单抗 玻璃体切除术 脱离 视网膜 牵引性 糖尿病性 

分 类 号：R587.2[医药卫生—内分泌] R779.6[医药卫生—内科学]