91例視網(wǎng)膜血管性疾病行玻璃體切除術(shù)聯(lián)合眼內(nèi)激光光凝的臨床分析
發(fā)布時間：2019-03-28 13:30
【摘要】：目的：探討行玻璃體切除術(shù)聯(lián)合眼內(nèi)激光光凝治療視網(wǎng)膜血管性疾病的病因構(gòu)成，，手術(shù)后視力及其影響因素，以更好地指導視網(wǎng)膜血管性疾病的治療。 方法：對我院眼科2009年9月至2011年10月期間收治的因視網(wǎng)膜血管性疾病行玻璃體切除術(shù)聯(lián)合眼內(nèi)激光光凝治療的91例患者（100只眼）的臨床資料進行回顧性分析。 結(jié)果：（1）91例患者100只眼中，PDR57人66只眼，年齡25～73歲，平均年齡54.23±9.85歲。BRVO10人10只眼，年齡41～75歲，平均年齡66.5±9.77歲。CRVO3人3只眼，年齡43～69歲，平均年齡58±13.45歲。HRP12人12只眼，年齡39～62歲，平均年齡55.08±7.10歲。Eales病9人9只眼，年齡19～59歲，平均年齡40.67±13.31歲。（2）手術(shù)前后視力比較有顯著的統(tǒng)計學差異（P=0.0000.05）。（3）不同疾病的術(shù)后視力改善率的差異無統(tǒng)計學意義（P=0.4720.05）。（4）PDR IV期術(shù)后視力改善率高于PDR V期和PDR VI期(P_(IV-V)=0.0100.0167, P_(IV-V)I=0.0040.0167)，PDR V期與PDR VI期術(shù)后視力改善率的差異無統(tǒng)計學意義（P_(V-VI)=0.6570.0167）。（5）術(shù)前行PRP的PDR與術(shù)前未行PRP的PDR術(shù)后視力改善率的差異比較無統(tǒng)計學意義（P=0.1620.05）。（6）PDR IV期玻璃體積血小于2個月的視力改善率比大于2個月的視力改善率高（P=0.029＜0.05）；RVO致玻璃體積血小于2個月和大于2個月視力改善率的差異無統(tǒng)計學意義（P=0.5920.05）。HRP致玻璃體積血小于2個月的視力改善率比大于2個月的視力改善率高（P=0.010＜0.05）。（7）術(shù)后未使用填充物組有41只眼（68.3%）視力改善，C3F8填充組有9只眼（37.5%）視力改善，硅油填充組有7只眼（43.8%）視力改善。（8）術(shù)中摘除白內(nèi)障24只眼，白內(nèi)障摘除聯(lián)合人工晶體植入的術(shù)后視力改善率（78.6%）高于保留晶狀體的術(shù)后視力改善率（55.3%）和白內(nèi)障摘除但未植入人工晶體的術(shù)后視力改善率（40.0%）。（9）術(shù)后并發(fā)癥包括早期眼壓升高、角膜水腫、玻璃體積血、黃斑囊樣水腫、新生血管性青光眼、并發(fā)性白內(nèi)障、視網(wǎng)膜脫離、視網(wǎng)膜中央動脈阻塞。 結(jié)論：（1）并發(fā)嚴重玻璃體積血和/或玻璃體視網(wǎng)膜增殖性改變的視網(wǎng)膜血管性疾病，行玻璃體切除術(shù)聯(lián)合眼內(nèi)激光光凝是挽救視力的有效方法。（2）視網(wǎng)膜血管性疾病術(shù)后的視力與原始疾病嚴重程度密切相關(guān)。（3）PDR患者早期行玻璃體切除術(shù)聯(lián)合眼內(nèi)激光光凝可以取得較好的預后視力。
[Abstract]:Aim: to investigate the etiological factors of vitrectomy combined with laser photocoagulation in the treatment of retinal vascular diseases (RVD), so as to better guide the treatment of retinal vascular diseases (RVD). Methods: the clinical data of 91 patients (100 eyes) who underwent vitrectomy combined with laser photocoagulation for retinal vascular diseases from September 2009 to October 2011 in our hospital were retrospectively analyzed. Results: (1) of the 91 patients, 66 eyes were PDR57 (age 25-73 years, mean age 54.23 鹵9.85 years), 10 eyes were BRVO10 patients (41-75 years old, mean age 66.5 鹵9.77 years), 3 eyes were CRVO3 people, and the average age was 43-69 years. The mean age of HRP12 was 58 鹵13.45 years old (12 eyes, 39 鹵62 years old, 55.08 鹵7.10 years old), 9 eyes of 9 patients with Eales disease, 19 eyes of 59 cases of Eales disease, 9 eyes of 9 patients and 9 eyes of 9 patients with Eales' disease. The mean age was 40.67 鹵13.31 years old. (2) there was a significant difference in postoperative visual acuity improvement rate between pre-and post-operative visual acuity (P = 0.0000.05). (3). There was no significant difference in postoperative visual acuity improvement rate between different diseases (P = 0.4720.05). (the visual acuity improvement rate of 4) PDR IV stage was higher than that of PDR V stage and PDR VI stage (P _ (IV-V) = 0.0100.0167, P _ (IV-V). P _ (IV-V) I _ (0.0040.0167), There was no significant difference in the postoperative visual acuity improvement rate between PDR V stage and PDR VI stage (P _ (V-VI) = 0.6570.0167). (5). There was no significant difference in the visual acuity improvement rate between pre-operation PDR and PDR without preoperative PRP (P _ (V-VI) = 0.6570.0167). (5). (P < 0. 1620.05). (6 -) PDR IV stage), the visual acuity improvement rate of vitreous hemorrhage less than 2 months was higher than that of more than 2 months (P < 0.05), and the visual acuity improvement rate of the patients with vitreous hemorrhage less than 2 months was higher than that of the patients with more than 2 months. There was no significant difference in visual acuity improvement rate between RVO-induced vitreous hemorrhage less than 2 months and more than 2 months (P < 0. 5920.05). HRP-induced vitreous hemorrhage less than 2 months), compared with vision improvement rates more than 2 months after vitreous hemorrhage (P < 0. 5920.05). HRP). The visual acuity of 41 eyes (68.3%) in the high (P < 0.05). (7) group after operation was improved, and the visual acuity was improved in 41 eyes (68.3%) in the non-filled group. In C3F8-filled group, visual acuity improved in 9 eyes (37.5%), in silicone oil-filled group in 7 eyes (43.8%). (8) Cataract was removed in 24 eyes during operation, and the visual acuity was improved in 7 eyes (43.8%) in silicone oil-filled group. The visual acuity improvement rate after cataract extraction combined with IOL implantation (78.6%) was higher than that after lens preservation (55.3%) and after cataract extraction without IOL implantation, the visual acuity improvement rate after cataract extraction without IOL implantation was higher than that after cataract extraction without IOL implantation (78.6%). (40. 0%). (- 9) postoperative complications included early elevation of intraocular pressure (IOP). Corneal edema, vitreous blood, macular cystic edema, neovascular glaucoma, complicated cataract, retinal detachment, central retinal artery occlusion. Conclusion: (1) Retinal vascular diseases complicated with severe vitreous hemorrhage and / or vitreoretinal proliferative changes. Vitrectomy combined with laser photocoagulation is an effective method to save visual acuity. (2) postoperative visual acuity of retinal vascular disease is closely related to the severity of primary disease. (3) early vitrectomy is performed in PDR patients. Combined with intraocular laser photocoagulation, better visual acuity can be obtained.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R779.6
本文編號：2448912
[Abstract]:Aim: to investigate the etiological factors of vitrectomy combined with laser photocoagulation in the treatment of retinal vascular diseases (RVD), so as to better guide the treatment of retinal vascular diseases (RVD). Methods: the clinical data of 91 patients (100 eyes) who underwent vitrectomy combined with laser photocoagulation for retinal vascular diseases from September 2009 to October 2011 in our hospital were retrospectively analyzed. Results: (1) of the 91 patients, 66 eyes were PDR57 (age 25-73 years, mean age 54.23 鹵9.85 years), 10 eyes were BRVO10 patients (41-75 years old, mean age 66.5 鹵9.77 years), 3 eyes were CRVO3 people, and the average age was 43-69 years. The mean age of HRP12 was 58 鹵13.45 years old (12 eyes, 39 鹵62 years old, 55.08 鹵7.10 years old), 9 eyes of 9 patients with Eales disease, 19 eyes of 59 cases of Eales disease, 9 eyes of 9 patients and 9 eyes of 9 patients with Eales' disease. The mean age was 40.67 鹵13.31 years old. (2) there was a significant difference in postoperative visual acuity improvement rate between pre-and post-operative visual acuity (P = 0.0000.05). (3). There was no significant difference in postoperative visual acuity improvement rate between different diseases (P = 0.4720.05). (the visual acuity improvement rate of 4) PDR IV stage was higher than that of PDR V stage and PDR VI stage (P _ (IV-V) = 0.0100.0167, P _ (IV-V). P _ (IV-V) I _ (0.0040.0167), There was no significant difference in the postoperative visual acuity improvement rate between PDR V stage and PDR VI stage (P _ (V-VI) = 0.6570.0167). (5). There was no significant difference in the visual acuity improvement rate between pre-operation PDR and PDR without preoperative PRP (P _ (V-VI) = 0.6570.0167). (5). (P < 0. 1620.05). (6 -) PDR IV stage), the visual acuity improvement rate of vitreous hemorrhage less than 2 months was higher than that of more than 2 months (P < 0.05), and the visual acuity improvement rate of the patients with vitreous hemorrhage less than 2 months was higher than that of the patients with more than 2 months. There was no significant difference in visual acuity improvement rate between RVO-induced vitreous hemorrhage less than 2 months and more than 2 months (P < 0. 5920.05). HRP-induced vitreous hemorrhage less than 2 months), compared with vision improvement rates more than 2 months after vitreous hemorrhage (P < 0. 5920.05). HRP). The visual acuity of 41 eyes (68.3%) in the high (P < 0.05). (7) group after operation was improved, and the visual acuity was improved in 41 eyes (68.3%) in the non-filled group. In C3F8-filled group, visual acuity improved in 9 eyes (37.5%), in silicone oil-filled group in 7 eyes (43.8%). (8) Cataract was removed in 24 eyes during operation, and the visual acuity was improved in 7 eyes (43.8%) in silicone oil-filled group. The visual acuity improvement rate after cataract extraction combined with IOL implantation (78.6%) was higher than that after lens preservation (55.3%) and after cataract extraction without IOL implantation, the visual acuity improvement rate after cataract extraction without IOL implantation was higher than that after cataract extraction without IOL implantation (78.6%). (40. 0%). (- 9) postoperative complications included early elevation of intraocular pressure (IOP). Corneal edema, vitreous blood, macular cystic edema, neovascular glaucoma, complicated cataract, retinal detachment, central retinal artery occlusion. Conclusion: (1) Retinal vascular diseases complicated with severe vitreous hemorrhage and / or vitreoretinal proliferative changes. Vitrectomy combined with laser photocoagulation is an effective method to save visual acuity. (2) postoperative visual acuity of retinal vascular disease is closely related to the severity of primary disease. (3) early vitrectomy is performed in PDR patients. Combined with intraocular laser photocoagulation, better visual acuity can be obtained.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R779.6
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相關(guān)期刊論文 前2條
1 趙志剛,,馬書平,,張菱,,田清芬,,文世林,,付曉英,,李全忠,,魯平,,周焰,,張春玲,大石まリこ,葛谷英嗣;2型糖尿病初診時視網(wǎng)膜病變的調(diào)查分析及中日比較[J];眼科研究;2000年05期
2 龐東渤,符麗娟,劉學政;糖尿病視網(wǎng)膜病變發(fā)病機制及治療研究進展[J];眼視光學雜志;2002年03期
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