不同原发病导致玻璃体积血患者行玻璃体切割手术的眼压变化分析  

Analysis on Intraocular Pressure in Eyes with Vitreous Hemorrage after Vitrectomy Caused by Different Primary Diseases

作　　者：周琳[1] 彭超[1] 沈孝军[1] ZHOU Lin;PENG Chao;SHEN Xiaojun(Jiangmen Central Hospital,Jiangmen 529000,China)

机构地区：[1]江门市中心医院,广东江门529000

出　　处：《中国医药指南》2021年第24期1-3,共3页Guide of China Medicine

基　　金：江门市科技计划项目(20150020002956)。

摘　　要：目的分析不同原发病导致的玻璃体积血患者行玻璃体切割手术后的眼压变化。方法选取2017年1月至2018年12月诊断为玻璃体积血的患者150例,依据原发病类型分为视网膜脱离(RD)组60例、糖尿病视网膜病变(DR)组50例、息肉状脉络膜血管病变(PCV)组40例,3组均为接受20 G玻璃体切割手术治疗的患者。记录3组手术前后的眼压、视网膜中央血流动力学参数及高眼压发生率,并进行对比。结果①眼压:术后7 d,3组患者眼压(t_(RD)=10.023,t_(PCV)=12.214,t_(DR)=17.764,均P=0.000)均较术前升高,差异均有统计学意义;术后30 d,3组患者眼压与术前差异均无统计学意义(P>0.05)。组间比较,术后7 d,DR组眼压高于RD组(t=9.886,P=0.000)和PCV组(t=7.895,P=0.000);术后30 d,3组患者眼压差异无统计学意义(P>0.05)。②血流参数:术后7 d、30 d,3组患者收缩期峰值流速、舒张末期流速均较术前升高,差异均有统计学意义(P<0.05)。组间比较,术后7 d,DR组收缩期峰值流速、舒张末期流速均低于RD组和PCV组,差异均有统计学意义(P<0.05)。术后30 d,3组视网膜血流参数比较,差异均无统计学意义(P>0.05)。③高眼压发生率:DR组发生率高于RD组(χ2=3.906,P=0.048)和PCV组(χ2=4.356,P=0.037),差异均有统计学意义;RD组和PCV组差异无统计学意义(P>0.05)。结论不同原发病导致的玻璃体积血患者行玻璃体切割手术治疗后,短时间内眼压及高眼压发生率存在明显的差异性,但对远期眼压无影响。Objective To analyze the intraocular pressure in eyes with vitreous hemorrage after vitrectomy caused by different primary diseases.Methods A total of 150 patients who underwent vitrectomy in our hospital from January 2017 to December 2018 were selected and divided into sixty cases of retinal detachment group,fifty cases of diabetic retinopathy group,and forty cases of polypoid choroid angiopathy group,and all the cases received conventional 20 G PPV.All the patients in the group were compared with the intraocular pressure,incidence of high intraocular pressure,and central retinal hemodynamic parameters in the three groups.Results(1)Intraocular pressure:seven days after surgery,the intraocular pressure(t_(RD)=10.023,t_(PCV)=12.214,t_(DR)=17.764,all P=0.000)was higher than that before surgery,and the differences were statistically significant.At thirty days after operation,there was no significant difference in IOP between the three groups and that before operation(P>0.05).(2)Blood flow parameters:on day 7 and 30 after surgery,the peak systolic flow rate and end-diastolic flow rate in 3 groups were higher than those before surgery,with statistical significance(P<0.05).On day 7 after surgery,the peak systolic flow rate and end-diastolic flow rate in DR group were lower than those in RD group and PCV group,with statistical significance(P<0.05).At 30 days after surgery,there was no significant difference in retinal blood flow parameters among the 3 groups(P>0.05).(3)The incidence of high IOP:the incidence of high IOP in DR group was higher than that in RD group(χ2=3.906,P=0.048)and PCV group(χ2=4.356,P=0.037),and the difference was statistically significant.There was no significant difference between RD group and PCV group(P>0.05).Conclusion There are obvious differences in the short-term IOP of vitrectomy in patients with different primary diseases,but it has no effect on the long-term IOP.

关 键 词：视网膜脱离 糖尿病视网膜病变 息肉状脉络膜血管病变 玻璃体切割手术 眼压 

分 类 号：R776.4[医药卫生—眼科]