雷珠单抗辅助23 G玻璃体切割术治疗增生性糖尿病视网膜病变

发布时间：2018-11-23 09:53

【摘要】：目的探讨23 G玻璃体切割术前玻璃体腔注射雷珠单抗(Ranibizumab,Lucentis)治疗增生性糖尿病视网膜病变手术难度的改善、手术并发症及疗效情况。方法回顾性分析我院2012年1月至2013年12月收治的174例(176眼)23 G玻璃体切割术治疗增生性糖尿病视网膜病变患者,其中2012年1月至12月92例(92眼)患者术前未进行玻璃体腔注射雷珠单抗作为非注射组(A组)、2013年1月至12月82例(84眼)患者术前先行玻璃体腔注射雷珠单抗0.05 mL作为注射组(B组)。比较2组患者所需手术时间、术中出血、医源性视网膜裂孔发生率及术后并发症、视力。结果 A组的手术时间为(116.22±17.46)min,B组为(80.49±18.11)min,2组比较差异有统计学意义(P0.05);术中A组较大量出血20眼,占21.7%,B组较大量出血4眼,占4.7%,2组比较差异有统计学意义(χ2=5.563,P0.05);A组医源性视网膜裂孔24眼(26.1%),B组医源性视网膜裂孔4眼(4.7%),差异有统计学意义(χ2=7.704,P0.05)。术后随访期内,A组再出血8眼,其中4眼出现再增殖合并局限性牵拉性视网膜脱离需要再手术,B组未见再出血及再增殖的病例,视网膜均平伏。术后视力:A组为手动~0.3,B组为手动~0.5,2组间差异无统计学意义(P0.05),但2组术前、术后视力组内比较差异均有统计学意义(均为P0.05)。结论23 G玻璃体切割术前注射雷珠单抗可以缩短手术时间,减少增生性糖尿病视网膜病变玻璃体手术中医源性视网膜裂孔、术中出血和术后出血发生率,并且术后没有明显的并发症。
[Abstract]:Objective to investigate the improvement of surgical difficulty, surgical complications and curative effect of 23 G vitrectomy with intravitreous injection of Lei Zhu McAb (Ranibizumab,Lucentis) in the treatment of proliferative diabetic retinopathy. Methods 174 patients (176 eyes) with proliferative diabetic retinopathy treated with 23 G vitrectomy from January 2012 to December 2013 were retrospectively analyzed. From January to December 2012, 92 patients (92 eyes) were not treated with vitreous intravitreal injection of Rayzumab as non-injection group (group A). From January to December, 2013, 82 patients (84 eyes) were treated with vitreous intravitreal injection of Lei Zhu McAb (0. 05 mL) as injection group (group B). The operative time, intraoperative bleeding, incidence of iatrogenic retinal rupture, postoperative complications and visual acuity were compared between the two groups. Results the operative time of group A was (116.22 卤17.46) min,B group was (80.49 卤18.11) min,2 group, the difference was statistically significant (P0.05). There were 20 eyes of massive hemorrhage in group A (21.7 eyes) and 4 eyes in group B (4.7 eyes). There was significant difference between group A and group B (蠂 2, 5.563%, P0.05). In group A, 24 eyes (26.1%), B) had iatrogenic retinal hiatus (4 eyes (4.7%), the difference was statistically significant (蠂 2 7.704 P 0.05). During the follow-up period, 8 eyes of group A had rebleeding, of which 4 eyes with reproliferation and local traction retinal detachment needed reoperation. In group B, there were no cases of rebleeding and reproliferation, and retina was flat. Postoperative visual acuity: the visual acuity of group A was manual to 0.3B group, there was no significant difference between group A and group B (P0.05), but there were significant differences between two groups before and after operation (P0.05). Conclusion 23 G vitrectomy can shorten the operation time and reduce the incidence of iatrogenic retinal rupture, intraoperative hemorrhage and postoperative hemorrhage in vitreous surgery for proliferative diabetic retinopathy. There were no obvious postoperative complications.
【作者单位】：南昌大学研究生院医学部;南昌爱尔眼科医院;
【分类号】：R779.6

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