增殖性糖尿病性视网膜病变患者玻璃体切割术前应用抗VEGF药物29例疗效观察  

Clinical Observation of 29 Cases of Proliferative Diabetic Retinopathy Treated with Anti-VEGF Drugs Before Vitrectomy

作　　者：李丽萍 徐玉霜 汪懿 李财保 LI Liping;XU Yushuang;WANG Yi;LI Caibao(The Second People's Hospital of Jingdezhen,Jingdezhen Jiangxi 333000,China)

机构地区：[1]景德镇市第二人民医院,江西景德镇333000

出　　处：《药品评价》2023年第8期976-979,共4页Drug Evaluation

基　　金：景德镇市科技局科技计划项目(20211SFZC037)。

摘　　要：目的探讨增殖性糖尿病性视网膜病变(PDR)患者在进行23G玻璃体切割手术之前,使用抗血管内皮生长因子(VEGF)药物对其手术疗效的影响。方法选取景德镇市第二人民医院2021年1月至2022年12月期间PDR患者43人共52只患眼作为研究对象。术前按照随机数字表法将患者分为两组,试验组29人共32只患眼,术前第5~7天在玻璃体腔内注入适量抗VEGF药物;对照组14人共20只患眼,无玻璃体腔内药物注射。对比两组手术持续时间、术中出血和术后高眼压等并发症以及视力恢复情况。结果试验组手术持续时间少于对照组,术中玻璃体腔内填充物使用次数低于对照组,术后视力好转率两组差异无统计学意义(P>0.05)。试验组术中及术后出血率、术后高眼压发生率均低于对照组(P<0.05)。结论玻璃体切割手术前使用抗VEGF药物,可以在一定程度上减少PDR患者术中及术后出血的发生率,从而提高手术效率,缩短手术时间,改善术后视力,还可以减少术中及术后并发症的发生,值得临床上推广应用。Objective To investigate the effect of anti-VEGF drugs on surgical outcomes in patients with proliferative diabetic retinopathy(PDR)prior to vitrectomy.Methods 43 patients and 52 eyes diagnosed with proliferative diabetic retinopathy(PDR)between January 2021 and December 2022 from The Second People's Hospital of Jingdezhen were selected for the study.The affected eyes were randomly divided into two groups,the experimental group had 29 individuals and 32 affected eyes,and anti-VEGF drugs were injected into the intravitreal 5 to 7 days before surgery;the control group consisted of 14 individuals with 20 affected eyes and no intravitreal drug injections.The time of surgery,intraoperative bleeding and postoperative complications as well as changes in visual acuity at 1 month follow-up were observed and statistically analyzed in both groups.Results The duration of surgery in the experimental group was less than that of the control group,the frequency of intraoperative intraocular filler use was less than that of the control group,and the rate of postoperative visual acuity improvement was higher than that of the control group,but the difference was not statistically significant(P>0.05).The intraoperative and postoperative hemorrhage rate and the incidence of postoperative hypertension were lower in the experimental group than in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of anti-VEGF drugs before vitrectomy in PDR patients can effectively improve the efficiency of surgery,reduce the incidence of intraoperative bleeding,shorten the operating time,improve postoperative visual acuity,and also reduce the occurrence of postoperative complications,which deserves to be promoted and applied clinically.

关 键 词：血管内皮生长因子类 糖尿病视网膜病变 康柏西普 玻璃体切割手术 

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