内界膜剥除在增生性糖尿病视网膜病变合并玻璃体积血患者手术中应用的短期临床研究  

A Short-term Clinical Study of Limiting Membrane Peeling in Patients with Proliferative Diabetic Retinopathy Complicated with Vitreous Hemorrhage

作　　者：张蕊 张维 朱恺 李旭冉 周恩亮 顾起宏 李晓俊 顾永昊 ZHANG Rui;ZHANG Wei;ZHU Kai(Ophthalmology Departmen,Provincial Hospital affiliated with Anhui Medical University,Hefei,Anhui,230001;Ophthalmology Department,The First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),Hefei,Anhui,230001)

机构地区：[1]安徽医科大学附属省立医院眼科,安徽合肥230001 [2]中国科学技术大学附属第一医院(安徽省立医院)眼科,安徽合肥230001 [3]蚌埠医科大学研究生院,安徽蚌埠233000

出　　处：《实用防盲技术》2025年第1期1-4,共4页Journal of Practical Preventing Blind

基　　金：安徽省自然科学基金项目(NO.1908085MH254)。

摘　　要：目的观察玻璃体切割术(PPV)联合内界膜剥除(ILMP)治疗合并玻璃体积血(VH)的增生性糖尿病视网膜病变(PDR)患者的临床效果。方法2022年6月至2023年6月在中国科学技术大学附属第一医院收治的PDR伴VH患者,PPV术中发现黄斑中心凹500μm内有硬性渗出和/或黄斑区牵拉变形,共50例50只眼纳入研究。随机将患者分为实验组(PPV联合ILMP)和对照组(单纯PPV),两组各25例25只眼。所有患者术前和术后随访时均行最佳矫正视力(BCVA)光学相干断层扫描(OCT)等相关眼科检查,PPV术中彻底清除玻璃体,实验组患者在吲哚菁绿染色辅助下剥除约1-2PD范围内界膜。随访1月,记录患者术后1周和1月时BCVA及黄斑中心凹厚度(CMT)。结果术后1周、1月,实验组BCVA与对照组对比无显著差异(P>0.05),而实验组CMT明显低于对照组(274.17±73.15vs400.29±125.93;244.09±19.82vs 321.11±92.93),差异有统计学意义(P<0.05)。结论对于PDR伴VH患者,PPV联合ILMP能有效降低患者术后CMT。Objective To observe the clinical outcomes of vitrectomy(PPV)combined with internal limiting membrane peeling(ILMP)in the treatment of proliferative diabetic retinopathy(PDR)complicated with vitreous hemorrhage(VH).Methods 50 patients with 50 eyes diagnosed with VH caused by PDR from June 2022 to June 2023 in the First Affiliated Hospital of University of Science and Technology were included in the study.Hard exudation and/or traction deformation within 500μm of macular fovea were confirmed with all cases during pars plana vitrectomy(PPV).Patients were divided into experimental group(PPV combined with ILMP,25 patients)and control group(PPV,25 patients)randomly.Posterior cortical vitreous was completely cleared,and in the experimental group,the ILM within a circular area of 1-2PD around the fovea was removed with the assistance of indocyanine green staining.BCVA and macular fovea thickness(CMT)were recorded at 1 week and 1 month after surgery.Results 1 week and 1 month after operation,BCVA of the experimental group was not significantly different from that of the control group,while CMT of the experimental group was significantly lower than that of the control group(P<0.05).Conclusion For patients with PDR and VH,PPV combined with ILMP could effectively reduce postoperative CMT.

关 键 词：玻璃体切割术 内界膜剥除 增生性糖尿病视网膜病变 

分 类 号：R779.6[医药卫生—眼科] R587.2[医药卫生—临床医学] R774.1