摘要
目的探讨雷珠单抗联合玻璃体切割治疗增生性糖尿病视网膜病变(PDR)的临床应用价值。方法回顾性分析本院2014年11月至2017年6月的206例(277眼) PDR患者的临床资料,根据治疗方法分为2组:对照组(100例,129眼)仅予以玻璃体切割手术;观察组(106例,148眼)在术前1周行玻璃体腔注射雷珠单抗0. 5 mg。统计患者临床手术情况,手术前后进行视力、眼压、眼科A/B超、裂隙灯显微镜、光学相干断层成像术(OCT)及眼底照相等影像学检查;术后随访6个月以上,统计术后并发症。结果观察组手术时间短于对照组,术中电凝止血次数少于对照组,视网膜裂孔发生率也低于对照组,组间差异均有统计学意义(P <0. 05)。治疗前,2组患者的视力与眼压相当,差异无统计学意义(P> 0. 05);治疗后,观察组视力优于对照组,眼压低于对照组,差异有统计学意义(P均<0. 05)。受到出血的影响,术前OCT检查很难获得清晰视野。玻璃体切除后6个月,观察组黄斑区中央凹视网膜厚度小于对照组,组间差异有统计学意义(P <0. 05)。观察组术后并发症发生率明显低于对照组,2组间的差异有统计学意义(P <0. 05)。结论玻璃体切割术前予以玻璃体腔注射雷珠单抗,有利于促进新生血管消退,减少术中出血和术后并发症,对提高PDR的治疗效果具有重要价值。
AIM To explore the clinical application value of ranibizumab combining vitrectomy to treatpoliferative diabetic retinopathy( PDR) . METHODS Totally 206 patients( 277 eyes) with PDR were selected,which were divided into 2 groups according to therapeutic method. The patients of the control group ( 100 patients,129 eyes) were treated with vitrectomy,while those of the observation group ( 106 patients,148 eyes) were treatedwith ranibizumab combining vitrectomy. The clinical operation situation of patients were recorded,and the eye-sight,intraocular pressure,A/B-mode ultrasound,slit-lamp microscope,optical coherence tomography ( OCT)and fundus photography were recorded too before and after operation. Further more,a follow up above 6 monthswere completed to observe postoperative complications. RESULTS The operation time of the observation groupwas shorter than that of the control group,the times of electrocoagulation hemostasis during operation of the obser-vation group was less than those of the control group,the retinal tear rate of the observation group was lower thanthat of the control group,and the difference had statistical significance ( P <0. 05) . Before treatment,there was nosignificant difference in eyesight and intraocular pressure between 2 groups ( P >0. 05) . After treatment,the eye-sight of the observation group was higher,the intraocular pressure of the observation group was lower than that ofthe control group,and the difference had statistical significance ( P <0. 05) . It was difficult to obtain clear OCT vision before surgery because of hemorrhage,6 months after surgery,the central concave retinal thickness of theobservation group was thinner,and the difference had statistical significance ( P <0. 05) . The postoperative com-plication rate of the observation group was lower than that of the control group,and the difference had statistical sig-nificance ( P <0. 05) . CONCLUSION Intravitreal injection of ranibizumab before vitrectomy is benefit for resis-ting revascularization and providing a good operating environment for surgery,which can reduce intraoperativebleeding and postoperative complications,and has important value to improve treatment effect of PDR.
作者
赵建国
徐建国
蒋自培
ZHAO Jianguo;XU Jianguo;JIANG Zipei(Department of Ophtalmology,The First Hospital of Wenzhou MedicalUniversity,Wenzhou 325000,China)
出处
《中国临床药学杂志》
CAS
2018年第6期371-376,共6页
Chinese Journal of Clinical Pharmacy
作者简介
第一作者:赵建国(1987-) ,男,硕士,住院医师。E-mail:jzial99@sina.com
