增生性糖尿病视网膜病变患眼玻璃体切除手术后玻璃体再积血的临床特征分析  

Clinical characteristics of vitreous hemorrhage after vitrectomy in patients with proliferative diabetic retinopathy

作　　者：冯姝颖 解正高 杨婉笛 华欣 Feng Shuying;Xie Zhenggao;Yang Wandi;Hua Xin(Department of Ophthalmology, Northern Jiangsu People's Hospital Affiliated Yangzhou University,Yangzhou 225001,China;.Department of Ophthalmology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Department of Ophthalmology,Hongquan Hospital,Yangzhou 225200,China)

机构地区：[1]扬州大学附属苏北人民医院眼科,225001

出　　处：《临床眼科杂志》2021年第4期294-298,共5页Journal of Clinical Ophthalmology

基　　金：江苏省研究生科研与实践创新计划项目(XSJCX19_115)。

摘　　要：目的观察并分析增生性糖尿病视网膜病变(PDR)患眼玻璃体切除手术后玻璃体再积血(PVH)的临床特征。方法回顾性病例研究。2015年12月至2018年12月在苏北人民医院确诊为PDR并行标准23G经睫状体平坦部三通道玻璃体切除术(PPV)治疗的291例(353只眼)患者纳入本研究,其中,男性138例(166只眼),女性153例(187只眼),年龄21~79岁,平均(52.40±9.59)岁。糖尿病病程(0.5~30)年,平均(11.53±6.43)年。采用SPSS23.0软件行统计学分析,分析评估全身、眼部和手术因素对PVH的影响。其中年龄、糖尿病病程、手术时长采用独立样本t检验,性别、合并肾损伤、合并高血压、合并血管疾病、合并虹膜新生血管、术前行抗血管内皮生长因子(VEGF)药物治疗、眼内填充物、术中联合白内障手术、术中并发症采用χ^(2)检验,对术前PDR分期、术前行全视网膜激光光凝(PRP)、术中视网膜情况采用非参数检验,根据单因素分析结果,将(P<0.2)的变量纳入二分类logistics回归分析,(P<0.05)为差异有统计学意义。结果291例(353只眼)中,发生PVH有28只眼(7.93%),对于PVH与非PVH组,术前行PRP差异有统计学意义(P=0.034,OR=0.267)。结论PDR患者术前行PRP可减少PVH的发生。Objective To assess and analyze the clinical characteristics of vitreous hemorrhage(VH)after vitrectomy in patients with proliferative diabetic retinopathy(PDR).Methods From December 2015 to December 2018,291 patients(353 eyes)diagnosed with PDR and treated with standard 23G pars plana vitrectomy(PPV)at the Subei People's Hospital were included in this study for retrospective analysis.There were 138 males(166 eyes)and 153 females(187 eyes),aged from 21 to 79 years old(average age:52.40±9.59 years)and the duration of diabetes mellitus ranged from 0.5 to 30 years(average duration:11.53±6.43 years).The SPSS 23.0 software was used to analyze the influence of systemic,ocular and surgical factors on postoperative vitreous hemorrhage(PVH).Independent sample t-test was used for age,diabetes duration,the surgery duration.Chi-square test was used for gender,presence of kidney injury,hypertension,vascular disease,iris neovascularization lines,preoperative retina laser,preoperative anti-vascular endothelial growth factor(VEGF)therapy,intraoperative retinal situation,intraocular tamponade,combined cataract surgery,and intraoperative complications.The PDR preoperative staging was analyzed by nonparametric test.According to the results of univariate analysis was considered statistically significant.Variables with(P<0.2)were included in dichotomy logistics regression analysis,and(P<0.05)was considered statistically significant.Results Among the 291 cases(353 eyes),PVH occurred in 28 eyes(7.93%).Preoperative pan-retinal photocoagulation showed a statistically significant difference between the PVH group and non-PVH group(P=0.034,OR=0.267).Conclusions Preoperative retinal laser photocoagulation can reduce the risk of PVH.

关 键 词：糖尿病视网膜病变 玻璃体切除术 玻璃体积血 临床特征 

分 类 号：R58[医药卫生—内分泌]