發(fā)布時間：2018-06-21 09:45

  本文選題：糖尿病性視網(wǎng)膜病變 + Avastin��； 參考：《吉林大學(xué)》2010年碩士論文

【摘要】： 目的：探討Avastin行玻璃體腔內(nèi)注射對于增殖型糖尿病性視網(wǎng)膜病變行玻璃體切割手術(shù)療效的影響。 方法：回顧分析2008年10月至2009年12月,我院收治并行玻璃體切割術(shù)治療的54例(62只眼)增殖型糖尿病性視網(wǎng)膜病變患者的臨床資料,根據(jù)術(shù)前是否應(yīng)用Avastin,分為注射組和對照組,其中28例(31只眼)先行Avastin玻璃體腔內(nèi)注射,而后行玻璃體切割術(shù),另外26例(31只眼)直接行玻璃體切割術(shù)。 結(jié)果：Avastin眼內(nèi)注射后未發(fā)現(xiàn)明顯眼部及全身并發(fā)癥,5-7天后均觀察到眼底新生血管膜纖維化、萎縮,行玻璃體切割手術(shù)術(shù)中易于剝除增殖膜,減少了膜殘留,且術(shù)中出血、發(fā)生醫(yī)源性裂孔的情況大大減少,手術(shù)時間明顯小于對照組。術(shù)后視力改善情況優(yōu)于對照組,術(shù)后再出血的幾率降低,無明顯并發(fā)癥發(fā)生。術(shù)后隨訪FFA檢查,注射組出現(xiàn)黃斑水腫、大片無灌注區(qū)及發(fā)生新生血管滲漏的病例明顯少于對照組。 結(jié)論：1.PDR患者Avastin眼內(nèi)注射后短期內(nèi)即發(fā)生新生血管膜纖維化、萎縮。2.PDR患者Avastin眼內(nèi)注射后再行玻璃體切割術(shù)因增殖膜易于剝除可提高手術(shù)效率,節(jié)約手術(shù)用時,且減少了術(shù)中出血、醫(yī)源性裂孔、術(shù)后再次出血等并發(fā)癥的發(fā)生。3.PDR患者Avastin眼內(nèi)注射對玻璃體切割術(shù)后的視力改善有積極作用,對術(shù)后PDR的進(jìn)展有抑制作用。4.Avastin眼內(nèi)注射有較高的安全性。5.PDR患者Avastin眼內(nèi)注射后行玻璃體切割術(shù)的最佳手術(shù)時機尚需進(jìn)一步探討。
[Abstract]:Objective: to investigate the effect of intravitreal injection of Avastin on vitrectomy for proliferative diabetic retinopathy. Methods: the clinical data of 54 patients with proliferative diabetic retinopathy treated with vitrectomy and vitrectomy in our hospital from October 2008 to December 2009 were retrospectively analyzed. The patients were divided into injection group and control group according to whether Avastin was used before operation or not. Among them, 28 cases (31 eyes) received intravitreous injection of Avastin, then vitrectomy, and 26 cases (31 eyes) underwent vitrectomy. Results after intraocular injection, no obvious ocular and systemic complications were observed. After 5-7 days, fibrotic fundus neovascularization and atrophy were observed. During vitrectomy, the proliferative membrane was easily removed, membrane residue was reduced, and hemorrhage occurred during the operation. The incidence of iatrogenic hiatus was greatly reduced and the operative time was significantly shorter than that in the control group. The postoperative visual acuity was better than that in the control group. Follow-up FFA showed that macular edema was found in the injection group, no perfusion area and neovascularization leakage in the injection group were significantly less than those in the control group. Conclusions 1. Neovascularization fibrosis occurred shortly after intraocular injection of Avastin in patients with Avastin, atrophy. 2. Vitrectomy after intraocular injection of Avastin in patients with PDR could improve the efficiency of operation and save the time of operation because of the easy excision of proliferative membrane. The complications such as intraoperative hemorrhage, iatrogenic laceration and postoperative rebleeding were reduced. 3. Intraocular injection of Avastin had positive effect on the improvement of visual acuity after vitrectomy. 4. The higher safety of intraocular injection of Avastin. 5. The best time for vitrectomy after intraocular injection of Avastin needs to be further explored.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R774.5

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本文編號：2048148