玻璃体切除术前不同时间注射抗VEGF治疗增生性糖尿病视网膜病变的效果  

Efficacy of intravitreal injection of anti-VEGF at different time before pars plana vitrectomy on the treatment of proliferative diabetic retinopathy

作　　者：潘金锌 周明[1] 刘豪杰[1] 何浩然 严鑫 Pan Jinxin;Zhou Ming;Liu Haojie;He Haoran;Yan Xin(Department of Ophthalmology,the Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,China)

机构地区：[1]大连大学附属中山医院眼科,大连116001

出　　处：《中华眼外伤职业眼病杂志》2022年第12期935-940,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的比较玻璃体切除术(PPV)前不同时间间隔玻璃体腔内注射康柏西普治疗增生性糖尿病视网膜病变(PDR)的效果。方法前瞻性随机对照研究。分析2020年12月至2021年8月大连大学附属中山医院眼科收治的PDR 90例(90眼)的临床资料。简单随机分为A、B、C三组, 每组各30例(30眼)。A组PPV术前3~4 d玻璃体内注射康柏西普, B组为PPV术前5~7 d玻璃体内注射康柏西普, C组仅行PPV。收集患者性别、年龄及糖尿病病程。统计手术时间、术中出血率、硅油填充率。随访6个月, 观察其最佳矫正视力(BCVA)、眼压和黄斑中心区视网膜厚度(CMT)。结果本研究3组患者术前BCVA差异无统计学意义(P>0.05)。治疗后, A组与B组的手术时间[(85.50±21.63)min, (115.00±21.62)min]、术中出血率[17%(5/30), 13%(4/30)]及硅油填充率[23%(7/30), 20%(6/30)]均低于C组的[(115.00±21.62)min、50%(15/30)、73%(22/30)](均P<0.05)。A组与B组术后BCVA比较差异无统计学意义(P>0.05), A组与C组、B组与C组术后BCVA比较差异均有统计学意义(均P<0.05)。三组患者术前及术后眼压比较差异无统计学意义(P>0.05)。结论 PDR患者玻璃体切除术前玻璃体内注射康柏西普能有效缩短手术时间, 减少术中并发症, 并能显著提高患者最佳矫正视力。玻璃体切除术前3~4 d和术前5~7 d注射康柏西普的效果相似。ObjectiveTo compare the efficacy of intravitreal injection of conbercept at different intervals in the treatment of proliferative diabetic retinopathy(PDR)before pars plana vitrectomy(PPV).MethodsThis was a prospective randomized controlled study.The clinical data of 90 eyes of 90 PDR patients admited to the Affiliated Zhongshan Hospital of Dalian University from Dec.2020 to Aug.2021 were analyzed.All cases were randomly divided into three groups:group A,group B and group C,with 30 eyes of 30 cases in each group.All the three groups underwent standard 23G vitrectomy through the flat part of the ciliary body.Group A received intravitreal injection of conbercept at 3-4 days before PPV,group B received intravitreal injection of Conbercept at 5-7 days before operation,and group C only received PPV.Gender,age and duration of diabetes were collected.The operation time,intraoperative bleeding rate and silicone oil filling rate were analyzed.ResultsThere was no significant difference in preoperative BCVA among the three groups in this study(P>0.05).After treatment,the operative time[(85.50±21.63)min,(115.00±21.62)min],intraoperative bleeding rate[17%(5/30),13%(4/30)Jand silicone oil filling rate[23%(7/30),20%(6/30)Jin group A and group B,were lower than those in group C[(115.00±21.62)min,50%(15/30),73%(22/30)J(P<0.05).There was no statistically significant difference in postoperative BCVA between group A and group B(P>0.05),and there were statistically significant differences in postoperative BCVA between group A and group C,between group B and group C(all P<0.05).There was no significant difference in IOP among the three groups before and after operation(P>0.05).Conclusion Intravitreal injection of conbercept before vitrectomy can effectively shorten the operation time,reduce intraoperative complications,and significantly improve BCVA.The efficacy of intravitreal injection of conbercept at 3-4 days before vitrectomy and intravitreal injection of conbercept at 5-7days beforevitrectomy were similar.

关 键 词：增生性糖尿病视网膜病变 玻璃体切除术 康柏西普 

分 类 号：R779.6[医药卫生—眼科] R587.2[医药卫生—临床医学]