[1]冯希敏,祁颖,张凤妍,等.玻璃体内注射雷珠单抗联合玻璃体切割术治疗增生型糖尿病视网膜病变的疗效观察[J].眼科新进展,2016,36(11):1079-1081.[doi:10.13389/j.cnki.rao.2016.0288]
　FENG Xi-Min,QI Ying,ZHANG Feng-Yan,et al.Intravitreal injection of ranibizumab combined with vitrectomy for proliferative diabetic retinopathy[J].Recent Advances in Ophthalmology,2016,36(11):1079-1081.[doi:10.13389/j.cnki.rao.2016.0288]
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玻璃体内注射雷珠单抗联合玻璃体切割术治疗增生型糖尿病视网膜病变的疗效观察
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
36卷
期数:
2016年11期
页码:
1079-1081
栏目:
应用研究
出版日期:
2016-11-05

文章信息/Info

Title:
Intravitreal injection of ranibizumab combined with vitrectomy for proliferative diabetic retinopathy
作者:
冯希敏; 祁颖; 张凤妍; 赵庆新; 秦云凤
453000　河南省新乡市，新乡市中心医院眼科（冯希敏，赵庆新，秦云凤）；450052　河南省郑州市，郑州大学第一附属医院眼科（祁颖，张凤妍）
Author(s):
FENG Xi-Min;  QI Ying;  ZHANG Feng-Yan;  ZHAO Qing-Xin;  QIN Yun-Feng
Department of Ophthatmology ,Xinxiang Central Hospital ( FENG Xi-Min, ZHAO Qing-Xin, QIN Yun-Feng ) ,Xinxiang 453000 , Henan Province, China; Department of Ophthalmology , the First Affiliated Hospital of Zhengzhou University ( QI Ying, ZHANC Feng-Yan ) , Zhengzhou 450052 , Henan Province , China
关键词:
糖尿病视网膜病变; 雷珠单抗; 玻璃体内注射; 玻璃体切割术
Keywords:
diabetic retinopathy ;  ranibizumab ; intravitreal injection ;  vitrectomy
分类号:
Ｒ７７４.１
DOI:
10.13389/j.cnki.rao.2016.0288
文献标志码:
A
摘要:
目的　评价玻璃体内注射雷珠单抗联合玻璃体切割术治疗增生型糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＰＤＲ）的临床疗效。方法　回顾性分析郑州大学第一附属医院２０１５年７月至２０１６年１月就诊的ＰＤＲ患者共４５例（５７眼）。根据手术方式不同分为对照组和观察组，单纯行玻璃体切割术者为对照组，共２４例３１眼，年龄（５１．２７±１７．１５）岁；玻璃体切割术术前３～５ｄ行玻璃体内注射雷珠单抗者为观察组，共２１例２６眼，年龄（５０．３４±１３．９４）岁。随访时间为３～６个月。主要比较两组的最佳矫正视力（ｂｅｓｔｃｏｒｒｅｃｔｅｄｖｉｓｕａｌａｃｕｉｔｙ，ＢＣＶＡ）、黄斑中心凹厚度、手术时间和并发症。结果　两组术前ＢＣＶＡ比较差异无统计学意义（χ２＝２．５１１，Ｐ＞０．０５），两组术后ＢＣＶＡ比较，观察组明显高于对照组，差异有统计学意义（χ２＝１１．８３４，Ｐ＜０．０５）。两组术后ＢＣＶＡ与术前比较，均有不同程度提升，χ２ 值分别为１０．９２７、１８．９７０，差异均有统计学意义（均为Ｐ＜０．０５）。术后７ｄ观察组黄斑中心凹厚度明显较对照组薄，差异有统计学意义（ｔ＝７．０３４Ｐ＜０．０５），术后３个月两组黄斑中心凹厚度比较，差异无统计学意义（ｔ＝０．３７１，Ｐ＞０．０５）。两组术后３个月黄斑中心凹厚度与７ｄ时比较均明显变薄（ｔ值分别为８．７０６、５．４７３），差异均有统计学意义（均为Ｐ＜０．０５）。两组手术时间比较，观察组手术时间为（４２．７５±８．９０）ｍｉｎ，明显短于对照组的（７１．５８±１４．７８）ｍｉｎ，差异有统计学意义（ｔ＝９．０７５，Ｐ＜０．０５）。两组术中发生医源性裂孔的眼数比较，差异无统计学意义（χ２＝０．９３４，Ｐ＞０．０５）。对照组术中应用电凝止血次数明显多于观察组，差异有统计学意义（χ２＝２４．０９７，Ｐ＜０．０５）；对照组术中填充硅油的眼数明显高于观察组，差异有统计学意义（χ２ ＝８．１４８，Ｐ＜０．０５）；两组术后出血的眼数比较，差异无统计学意义（χ２ ＝２．３５７，Ｐ＞０．０５）。结论　玻璃体切割术术前玻璃体内注射雷珠单抗可以提升术后ＢＣＶＡ、加快黄斑水肿消退、缩短手术时间、减少术中及术后并发症，提高手术安全性。
Abstract:
Objective To evaluate the clinical efficacy of intravitreal ranibizumab injection combined with vitrectomy for proliferative diabetic retinopathy ( PDR) . Methods 45 cases ( 57 eyes) with PDR in our hospital from July 2015 to January 2016 were chosen. The patients were randomly divided into two groups according to the different treatments : the patients in research group ( Male : 10 case , 13 eyes ; Female : 11 cases . 13 eyes) were treated with 0. 5 mg ranibizumab intravitreal injection 3 - 5 days before vitrectomy while the patients in control group ( Male : 11 case , 14 eyes ; Female : 13 cases . 17 eyes) were treated only by vitrectomy. The best corrected visual acuity ( BCVA) .macular thickness , operation time and complications were observed. Results There was no statistical difference in preoperative BCVA between two groups (X2 = 2. 511 ,P > 0. 05 ) . Compared with control group, the postoperative BCVA of research group was significantly better (Xz = 11. 834 ,P < 0. 05 ) . There were statistical differences in BCVA before and after operation (X2 = 10. 927 , 18. 970 ; all P < 0. 05 ) . At postoperative 7 days , the macular thickness in the research group was thinner than that in the control group ( t = 7. 034 .P < 0. 05 ) ,but there was no statistical difference at postoperative 3 months ( t = 0. 371 .P < 0. 05 ) . The macular thickness in two group at postoperative 3 months were thinner than that at postoperative 7 days ( t = 8. 706 .5. 473 ; all P < 0. 05 ) . The operation time in the research group was ( 42. 75 + 8. 90) minutes.which was significantly shorter than ( 71. 58 + 14. 78 ) minutes in the control group ( t = 9. 075 ,P < 0. 05 ) . There was no statistical difference in the incidence of iatrogenic retinal breaks between two groups (X2 = 0. 934 ,P > 0. 05 ) . The electric coagulation times in the control group was more than that in the research group (X2 = 24. 097 ,P < 0. 05 ) . The filler of silicon oil decreased obviously in research group (X2 = 19. 616 .P < 0. 05 ) . There was no statistical difference in the postoperative hemorrhage eyes between two groups (X2 = 2. 357 .P > 0. 05 ) . Conclusion Intravitreal ranibizumab injection before vitrectomy is helpful to improve the postoperative BCVA , reduce the operation time , decrease the macular thickness and complications , and increase the safety.

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更新日期/Last Update: 2016-11-29