雷珠单抗玻璃体腔注射联合小梁切除术+视网膜光凝术治疗新生血管性青光眼的疗效研究  

Efficacy of Intravitreal Injection of Ranibizumab Combined with Trabeculectomy+Retinal Photocoagulation in the Treatment of Neovascular Glaucoma

作　　者：杨梅[1] YANG Mei(Department of Ophthalmology,Jinxiang County People's Hospital,Jining,Shandong Province,272200 China)

机构地区：[1]金乡县人民医院眼科,山东济宁272200

出　　处：《系统医学》2022年第9期107-111,共5页Systems Medicine

摘　　要：目的探讨对新生血管性青光眼者在小梁切除术+视网膜光凝术治疗基础上联用雷珠单抗玻璃体腔内注射干预的效果。方法选择医院2020年1—12月收治的新生血管性青光眼者90例,按照随机数表法分为小梁切除术+视网膜光凝术治疗对照组(n=45)与联合雷珠单抗玻璃体腔内注射观察组(n=45),对比两组临床疗效,比较患者术前、术后1个月的最佳矫正视力与眼压,检测治疗前后血浆黏度(PV)、红细胞压积(HCT)、血小板黏附率(PADT)水平评估患者血液流变学指标改变。结果观察组总有效率较对照组高(97.78%vs 82.22%),差异有统计学意义(χ^(2)=4.444,P<0.05)。观察组术后最佳矫正视力(1.23±0.16),高于对照组,眼压(13.24±4.13)mmHg小于对照组,差异有统计学意义(t=4.417、4.366,P<0.05);观察组术后PV、HCT、PADT水平分别为(1.32±0.17)mPa/s、(35.76±4.25)%、(25.48±3.12)%,均小于对照组,差异有统计学意义(t=4.736、7.967、7.028,P<0.05)。结论对新生血管性青光眼采用雷珠单抗玻璃体腔注射联合小梁切除术+视网膜光凝术治疗疗效理想,能够改善患者术后视力与眼压以及血液流变学指标。Objective To investigate the effect of intravitreal injection of ranibizumab combined with trabeculectomy and retinal photocoagulation for neovascular glaucoma.Methods A total of 90 patients with neovascular glaucoma who were admitted to the hospital from January to December 2020 were selected.According to the random number table method,they were divided into trabeculectomy+retinal photocoagulation treatment group(n=45)and observation group combined with intravitreal injection of ranibizumab(n=45).The clinical efficacy of the two groups was compared.The best corrected visual acuity and intraocular pressure of the patients before and 1 month after the operation were compared,and the levels of plasma viscosity(PV),hematocrit(HCT),and platelet adhesion rate(PADT)before and after treatment were measured to evaluate the changes of hemorheological indexes of the patients.Results The total effective rate of the observation group was higher than that of the control group(97.78%vs 82.22%),and the difference was statistically significant(χ^(2)=4.444,P<0.05).The postoperative best corrected visual acuity of the observation group was(1.23±0.16),which was higher than that of the control group,and the intraocular pressure was(13.24±4.13)mmHg,which was lower than that of the control group,and the difference was statistically significant(t=4.417,4.366,P<0.05).The postoperative PV,HCT and PADT levels in the observation group were(1.32±0.17)mPa/s,(35.76±4.25)%,and(25.48±3.12)%,respectively,which was smaller than the control group,and the difference was statistically significant(t=4.736,7.967,7.028,P<0.05).Conclusion Intravitreal injection of ranibizumab combined with trabeculectomy+retinal photocoagulation is an ideal treatment for neovascular glaucoma,which can improve postoperative visual acuity,intraocular pressure and hemorheological indexes.

关 键 词：新生血管性青光眼 雷珠单抗 玻璃体腔内注射液 视网膜光凝术 小梁切除术 并发症 

分 类 号：R4[医药卫生—临床医学]