本文選題：視網(wǎng)膜中央靜脈阻塞 + 注射�。� 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:探討玻璃體腔內(nèi)注射康柏西普治療視網(wǎng)膜中央靜脈阻塞(central retinal vein occlusion,CRVO)繼發(fā)黃斑水腫(macular edema,ME)的效果。方法:篩選自2015年4月到2015年10月在本院經(jīng)臨床確診為視網(wǎng)膜中央靜脈阻塞繼發(fā)黃斑水腫的患者15例(15眼),進(jìn)行回顧性研究。在給予玻璃體腔注藥前檢查患者全身情況,有無(wú)全身疾病、不良嗜好;全面的眼科檢查,并備案治療前的視力情況、眼壓、光學(xué)相干斷層掃描(optical coherence tomography,OCT)、眼底照相等一系列眼科必須檢查。開(kāi)始治療后記錄并分析注射后1w、1m、3m、6m患者的最佳矯正視力(best-corrected visual acuity,BCVA)、眼壓、黃斑中心凹的視網(wǎng)膜厚度(central macular thickness,CMT)、眼底照相,以此用來(lái)和治療前做出比較。同時(shí)采用配對(duì)t檢驗(yàn)對(duì)最佳矯正視力(BCVA)和黃斑中心凹的視網(wǎng)膜厚度(CMT)兩組數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:全部患者在玻璃體腔內(nèi)注射康柏西普后最佳矯正視力均得到了不同程度的提高。治療前BCVA為1.15±0.22,治療后1w、1m、3m、6m的BCVA分別為0.98±0.25、0.92±0.26、0.82±0.32、0.70±0.29,治療前與治療后每次所得結(jié)果相比統(tǒng)計(jì)學(xué)分析差異有意義(p0.05);應(yīng)用光學(xué)相干斷層掃描(optical coherence tomography,OCT)測(cè)量黃斑中心凹的視網(wǎng)膜厚度(CMT)明顯變薄,治療前為596.13±54.30μm,治療后1w、1m、3m、6m分別為258.80±32.00μm、245.87±74.11μm、254.26±127.76μm、168.07±23.43μm,治療前和治療后所得結(jié)果經(jīng)過(guò)統(tǒng)計(jì)學(xué)分析差異有意義(p0.05)。在這個(gè)連續(xù)的隨訪(fǎng)過(guò)程中,部分患者在給予干預(yù)治療后會(huì)再次出現(xiàn)黃斑水腫,重復(fù)注射后黃斑中心凹的視網(wǎng)膜厚度(CMT)仍然可以明顯的降低。結(jié)論:玻璃體腔內(nèi)注射康柏西普治療CRVO繼發(fā)黃斑水腫,患者短期中心視力有所提高,黃斑水腫減輕,黃斑中心凹的視網(wǎng)膜厚度(CMT)數(shù)值和治療前比較降低。說(shuō)明該藥在對(duì)抗視網(wǎng)膜中央靜脈阻塞繼發(fā)的黃斑水腫有明顯的優(yōu)勢(shì),效果顯著,最終達(dá)到提高患者視力的目的,且操作方法相對(duì)簡(jiǎn)單,普遍能為患者所認(rèn)可。當(dāng)然,在長(zhǎng)期觀察過(guò)程中發(fā)現(xiàn)有病情反復(fù)的現(xiàn)象,再次經(jīng)過(guò)玻璃體腔注入康柏西普注射液后測(cè)量相干光學(xué)斷層掃描檢查發(fā)現(xiàn)水腫獲得了減輕,這說(shuō)明該藥周期尚待考量、研究,需要反復(fù)多次注射才能控制病情。
[Abstract]:Objective: to investigate the effect of intravitreal injection of Compactopril in the treatment of secondary macular edema (macular edemame) of central retinal vein occlusion (central retinal vein occlusion). Methods: 15 patients (15 eyes) with macular edema following central retinal vein occlusion were selected from April 2015 to October 2015. Examination of the patients' general condition, whether they have any systemic diseases, bad habits, comprehensive ophthalmological examination, and the record of their eyesight and intraocular pressure before they are given intravitreal injection. Optical coherence tomography (optical coherence tomography Oct), fundus photography and other ophthalmology must be examined. The best-corrected visual acuteness BCVA, intraocular pressure, retinal thickness of macular fovea (central macular thicknessn), and fundus photography were recorded and analyzed 1 week after treatment, and compared with those before treatment. The results were as follows: (1) at the beginning of treatment, the best corrected visual acuity (BCVA), intraocular pressure (IOP), retinal thickness of macular fovea (central macular thicknessn), and fundus photography were recorded and analyzed. The best corrected visual acuity (BCVA) and retinal thickness (CMT) of macular fovea were statistically analyzed by paired t test. Results: the best corrected visual acuity (BCVA) of all the patients was improved in varying degrees after intravitreal injection of Combortopril. BCVA was 1.15 鹵0.22 before treatment and 0.98 鹵0.25 鹵0.92 鹵0.32 鹵0.70 鹵0.29 at 1 week after treatment. The results before and after treatment were statistically significant (p0.05). The retinal thickness of macular fovea was measured by optical coherence tomography (optical coherence). It was 596.13 鹵54.30 渭 m before treatment and 258.80 鹵32.00 渭 m / 3 m at 1 week after treatment, respectively. The results were significantly different before and after treatment (p 0.05). During this continuous follow-up, macular edema was found again in some patients after intervention, and the retinal thickness (CMT) of the fovea was significantly decreased after repeated injection. Conclusion: in the treatment of CRVO secondary macular edema, the short-term central visual acuity was improved, macular edema was alleviated, and the retinal thickness (CMT) of macular fovea was decreased. The results showed that the drug had obvious advantages in the treatment of macular edema secondary to central retinal vein occlusion and achieved the goal of improving the visual acuity of the patients. The method of operation was relatively simple and could be generally accepted by the patients. Of course, during the long period of observation, it was found that there was a recurrence of the disease. After the injection of Compathep injection into the vitreous body, the measurement of coherence optical tomography showed that the edema had been alleviated, which indicated that the period of the drug was still to be considered. Multiple injections are needed to control the condition.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R774

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本文編號(hào)：2065959