Avastin眼内注射对糖尿病性视网膜病变行玻璃体切割手术的影响分析

发布时间：2018-06-21 09:45

本文选题：糖尿病性视网膜病变 + Avastin　；参考：《吉林大学》2010年硕士论文

【摘要】： 目的：探讨Avastin行玻璃体腔内注射对于增殖型糖尿病性视网膜病变行玻璃体切割手术疗效的影响。方法：回顾分析2008年10月至2009年12月,我院收治并行玻璃体切割术治疗的54例(62只眼)增殖型糖尿病性视网膜病变患者的临床资料,根据术前是否应用Avastin,分为注射组和对照组,其中28例(31只眼)先行Avastin玻璃体腔内注射,而后行玻璃体切割术,另外26例(31只眼)直接行玻璃体切割术。结果：Avastin眼内注射后未发现明显眼部及全身并发症,5-7天后均观察到眼底新生血管膜纤维化、萎缩,行玻璃体切割手术术中易于剥除增殖膜,减少了膜残留,且术中出血、发生医源性裂孔的情况大大减少,手术时间明显小于对照组。术后视力改善情况优于对照组,术后再出血的几率降低,无明显并发症发生。术后随访FFA检查,注射组出现黄斑水肿、大片无灌注区及发生新生血管渗漏的病例明显少于对照组。结论：1.PDR患者Avastin眼内注射后短期内即发生新生血管膜纤维化、萎缩。2.PDR患者Avastin眼内注射后再行玻璃体切割术因增殖膜易于剥除可提高手术效率,节约手术用时,且减少了术中出血、医源性裂孔、术后再次出血等并发症的发生。3.PDR患者Avastin眼内注射对玻璃体切割术后的视力改善有积极作用,对术后PDR的进展有抑制作用。4.Avastin眼内注射有较高的安全性。5.PDR患者Avastin眼内注射后行玻璃体切割术的最佳手术时机尚需进一步探讨。
[Abstract]:Objective: to investigate the effect of intravitreal injection of Avastin on vitrectomy for proliferative diabetic retinopathy. Methods: the clinical data of 54 patients with proliferative diabetic retinopathy treated with vitrectomy and vitrectomy in our hospital from October 2008 to December 2009 were retrospectively analyzed. The patients were divided into injection group and control group according to whether Avastin was used before operation or not. Among them, 28 cases (31 eyes) received intravitreous injection of Avastin, then vitrectomy, and 26 cases (31 eyes) underwent vitrectomy. Results after intraocular injection, no obvious ocular and systemic complications were observed. After 5-7 days, fibrotic fundus neovascularization and atrophy were observed. During vitrectomy, the proliferative membrane was easily removed, membrane residue was reduced, and hemorrhage occurred during the operation. The incidence of iatrogenic hiatus was greatly reduced and the operative time was significantly shorter than that in the control group. The postoperative visual acuity was better than that in the control group. Follow-up FFA showed that macular edema was found in the injection group, no perfusion area and neovascularization leakage in the injection group were significantly less than those in the control group. Conclusions 1. Neovascularization fibrosis occurred shortly after intraocular injection of Avastin in patients with Avastin, atrophy. 2. Vitrectomy after intraocular injection of Avastin in patients with PDR could improve the efficiency of operation and save the time of operation because of the easy excision of proliferative membrane. The complications such as intraoperative hemorrhage, iatrogenic laceration and postoperative rebleeding were reduced. 3. Intraocular injection of Avastin had positive effect on the improvement of visual acuity after vitrectomy. 4. The higher safety of intraocular injection of Avastin. 5. The best time for vitrectomy after intraocular injection of Avastin needs to be further explored.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R774.5

【参考文献】