曲安奈德对复杂性视网膜脱离玻璃体切除术后增生性玻璃体视网膜病变发生的预防作用

发布时间：2018-03-12 12:01

本文选题：曲安奈德　切入点：玻璃体切除术　出处：《兰州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:研究曲安奈德对复杂性视网膜脱离玻璃体切除术后增生性玻璃体视网膜病变发生的预防效果。方法:选取我院从2014年1月至2016年1月在我院收入院的80例复杂性视网膜脱离患者,包括大裂孔(裂孔直径大于3PD)、巨大裂孔性视网膜脱离患者(裂孔范围80°-160°)21眼,脉络膜脱离型视网膜脱离患者16眼,增生性玻璃体视网膜病变(PVR)C3以上的孔源性视网膜脱离患者20眼,孔源性视网膜脱离术后复发再次手术23眼。随机分为两组,每一组各40例病人,一组为对照组,行常规玻璃体切除手术,另一组为治疗组,行玻璃体切除手术时联合曲安奈德治疗。平均随访1年,比较两组患者治疗效果,术后增生性玻璃体视网膜病变发生情况,视网膜脱离复发率,视力改善情况及并发症。结果:两组的最佳矫正视力均较手术之前有所改善,手术前和手术后,两组间差异无统计学意义(P0.05);治疗组患者的有效率(视网膜取得解剖复位)为95.00%,对照组患者的有效率(视网膜取得解剖复位)为75.50%,两组差异显著(P0.05),有统计学意义;治疗组患者术后增生性玻璃体视网膜病变发生率为7.50%,术后视网膜脱离复发率为5.0%,与对照组相比两组差异显著(P0.05),有统计学意义;治疗组患者术后高眼压发生率和对照组比较无统计学意义(P0.05)结论:对复杂性视网膜脱离患者采用玻璃体切除术时联合曲安奈德治疗能预防增生性玻璃体视网膜病变的发生,提高患者的疗效,降低视网膜脱离复发,为该病患者的治疗提供较为科学的临床价值。
[Abstract]:Objective: to study the preventive effect of triamcinolone acetonide on proliferative vitreoretinopathy after vitrectomy in patients with complicated retinal detachment. Methods: 80 cases in our hospital from January 2014 to January 2016 were selected. Complicated retinal detachment, These include large holes (the diameter of which is larger than 3 PDD), giant retinal detachment (80 掳-160 掳) in 21 eyes, choroidal detachment in 16 eyes, and rhegmatogenous retinal detachment above PVRC3 in 20 eyes of proliferative vitreoretinopathy. 23 eyes with recurrence of rhegmatogenous retinal detachment were randomly divided into two groups, 40 patients in each group, one group was treated with routine vitrectomy, the other group was treated with vitrectomy. After vitrectomy combined with triamcinolone acetonide (triamcinolone acetonide), the results of treatment were compared between the two groups after vitrectomy, the incidence of proliferative vitreoretinopathy and the recurrence rate of retinal detachment were compared between the two groups. Results: the best corrected visual acuity (BCVA) in both groups was better than that before and after surgery. There was no significant difference between the two groups (P 0.05), the effective rate of treatment group (retina anatomical reattachment) was 95.00, the effective rate of control group (retina reattachment) was 75.50, the difference between the two groups was significant (P 0.05). The incidence of proliferative vitreoretinopathy in the treatment group was 7.50 and the recurrence rate of retinal detachment was 5.0. The difference between the two groups was significant (P 0.05). Conclusion: the combination of triamcinolone acetonide and vitrectomy can prevent proliferative vitreoretinopathy in patients with complicated retinal detachment. To improve the curative effect and reduce the recurrence of retinal detachment, it provides more scientific clinical value for the treatment of this disease.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R779.6

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