康柏西普预处理联合玻璃体切割术治疗增生型糖尿病视网膜病变

发布时间：2018-05-12 10:27

  本文选题：康柏西普 + 糖尿病视网膜病变　； 参考：《眼科新进展》2017年08期

【摘要】：目的探讨抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物康柏西普对增生型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者玻璃体切割术(pars plana vitrectomy,PPV)术中和术后的影响。方法将2016年1月至12月于我科确诊PDR伴有玻璃体出血(vitreous hemorrhage,VH)和(或)牵拉性视网膜脱离(tractional retinal detachment,TRD)的123例149眼患者纳入研究,其中康柏西普组64例78眼,对照组59例71眼。康柏西普组于PPV术前3 d玻璃体内注射抗VEGF药物0.50 mg(0.05 mL),对照组无处理。无明显并发症后2组行标准23G微创巩膜三通道玻璃体切割术,记录并分析手术时间、术中出血、医源性视网膜裂孔、眼内电凝使用、是否硅油填充等,对术前及术后1个月视力及黄斑厚度进行对比,观察术后并发症情况。结果两组患者年龄、性别、糖化血红蛋白、糖尿病病程,VH≥Ⅲ级眼数(56/78、45/71),术前TRD比较均无明显差异。康柏西普预处理可明显降低PPV术中出血(43/78、49/71)、医源性视网膜裂孔的概率(11/78、21/71),减少眼内电凝使用(57/78、62/71)及硅油填充(43/78、51/71),进而缩短手术时间(58.63±21.66)s、(72.69±22.48)s,且其可明显改善术后视力(0.23±0.15,0.16±0.11)及黄斑水肿厚度(260.95±27.44)μm、(330.81±36.62)μm,同时降低二次积血发生率(3/78、10/71)。结论康柏西普预处理联合PPV是治疗PDR患者一项积极有效的治疗方案。
[Abstract]:Objective to investigate the effect of anticancer vascular endothelial growth factor (VEGF) on proliferative diabetic retinopathy (PDR) in patients with proliferative diabetic retinopathy (PDR) during and after vitrectomy. Methods from January to December 2016, 123 patients (149 eyes) with PDR with vitreous hemorrhage and / or traction retinal detachment diagnosed in our department were included in the study, including 64 cases (78 eyes) and 59 cases (71 eyes) of control group. Compactopril group was injected intravitreous with anti VEGF drug 0. 50 mg(0.05 mL 3 days before PPV, while the control group was not treated. After no obvious complications, the two groups were treated with standard 23G minimally invasive three-channel scleral vitrectomy. The operative time, intraoperative bleeding, iatrogenic retinal rupture, intraocular electrocoagulation and silicone oil filling were recorded and analyzed. Visual acuity and macular thickness were compared before and 1 month after operation, and postoperative complications were observed. Results the age, sex, glycosylated hemoglobin, VH 鈮，

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