康柏西普治疗增生性糖尿病视网膜病变

doi:10.6040/j.issn.1673-3770.0.2018.005

摘要/Abstract

摘要： 目的探讨术前预防性康柏西普玻璃体腔注射对增生性糖尿病视网膜病变(PDR)手术效果的影响,并分析预后的影响因素。方法对2015年1月至2017年6月接受玻璃体切割术的40例(54眼)PDR患者进行回顾性分析。将术前应用康柏西普玻璃体注射的20例(26眼)为治疗组,未应用康柏西普的20例(28眼)为对照组,对比两组手术及预后效果。根据视力改善效果测评预后,通过单因素及多因素分析分析预后的影响因素。结果治疗组手术时间短于对照组,医源性破孔、术中出血、术中电凝、硅油填充患眼数少于对照组,差异均有统计学意义。术前两组黄斑厚度对比,差异无统计学意义;术后治疗组黄斑厚度小于对照组,差异有统计学意义。两组视网膜复位率、术后玻璃体再积血率、术后视力恢复效果对比,差异均无统计学意义。较高的术前糖化血红蛋白水平、较高的术前黄斑厚度是患者预后的独立危险因素。结论术前预防性康柏西普玻璃体腔注射,能够提升PDR患者玻璃体切割术效果减少术中并发症,但该措施对患者视力恢复无明显影响。

关键词: 糖尿病视网膜病变, 玻璃体切割术, 康柏西普, 新生血管

Abstract: Objective To investigate the effect of preoperative prophylactic injection of conbercept into the vitreous cavity on proliferative diabetic retinopathy(PDR)and to analyze the factors influencing prognosis. Methods A retrospective analysis was performed on 40 patients(54 eyes)with PDR who underwent vitrectomy from January 2015 to June 2017. Of these, 20 patients(26 eyes, the observation group)received preoperative prophylactic intravitreal injection of conbercept and 20(28 eyes)without treatment were in the control group. The surgical outcomes and prognosis were compared between the 2 groups. Prognosis was evaluated according to the effect on visual improvement, and prognostic factors were analyzed using single and multiple factor analysis. Results The duration of surgery in the observation group was much shorter than in the control group. The incidence of iatrogenic perforation or intraoperative bleeding and the need for intraoperative electrocoagulation or silicone oil filling were much less in the observation group than in the control group, and the differences were statistically significant. There was no significant difference in macular thickness between the 2 groups before surgery. After surgery, the macular thickness in the observation group was much less than that in the control group, with a statistically significant difference. There was no significant difference between the 2 groups in the rate of retinal repositioning, postoperative vitreous reaccumulation, and recovery of visual acuity. Higher preoperative glycated hemoglobin levels and higher preoperative macular thickness were independent risk factors for prognosis. Conclusion Preoperative prophylactic intravitreal injection of conbercept can improve the effect of vitrectomy for PDR patients, and can help reduce complications. However, this measure had no obvious effect on recovery of visual acuity.

Key words: Diabetic retinopathy, Vitrectomy, Conbercept, Neovascularization

中图分类号:

R587.2

刘万智,陈珺,樊长春. 康柏西普治疗增生性糖尿病视网膜病变[J]. 山东大学耳鼻喉眼学报, 2018, 32(6): 88-91.

LIU Wanzhi, CHEN Jun, FAN Changchun. Clinical study of conbercept in the treatment of proliferative diabetic retinopathy[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(6): 88-91.

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