本文選題：增殖性糖尿病視網(wǎng)膜病 + 玻璃體切除術(shù)　； 參考：《大連醫(yī)科大學(xué)》2011年碩士論文

【摘要】：目的:探討增殖性糖尿病視網(wǎng)膜病變(proliferative diabetic retinopathy,PDR)的患者行硅油取出+人工晶體(Intraocular lens,IOL)植入術(shù)和二次人工晶體植入術(shù)的臨床療效。 方法設(shè)計(jì):回顧性分析2009年3月至2011年3月在本院經(jīng)同一手術(shù)醫(yī)師治療的因糖尿病視網(wǎng)膜病變行玻璃體切除+白內(nèi)障超聲乳化摘除+硅油注入術(shù)的患者45例(52只眼),男17例,女28例,年齡35-74歲,平均年齡58歲,患者均行過經(jīng)典三通道玻璃體切除+白內(nèi)障超聲乳化摘除+硅油注入術(shù),其中行硅油取出+人工晶體植入的患者26例(30只眼,其中雙眼4例8只眼,右眼10例10只眼,左眼12例12只眼),行二次人工晶體植入術(shù)者19例(22只眼,其中雙眼3例6只眼,右眼8例8只眼,左眼8例8只眼),糖尿病視網(wǎng)膜病變病程最短4年,最長(zhǎng)24年,平均9.2年。術(shù)后隨訪2年,平均8個(gè)月。觀察行兩種不同術(shù)式的患者視力改善程度。 結(jié)果:行硅油取出+人工晶體植入術(shù)的患者視力改善22只眼,占76.6%,行二次人工晶體植入的患者視力改善眼15只眼,占73.2%,兩組術(shù)后視力改善眼數(shù)比較差異不顯著(X2=0.08,P=0.995).52只眼均未發(fā)生嚴(yán)重并發(fā)癥,醫(yī)源性視網(wǎng)膜裂孔術(shù)中予以眼內(nèi)光凝,術(shù)中活動(dòng)性出血通過眼內(nèi)光凝或術(shù)中升高灌注瓶止血。 結(jié)論:在增生性視網(wǎng)膜病變患者的玻璃體手術(shù)中,硅油取出+人工晶體植入術(shù)和二次人工晶體植入術(shù)均可使大多數(shù)患者視力改善,兩種術(shù)后視力改善程度無明顯差異。
[Abstract]:Objective: to investigate the clinical effect of silicone oil extraction and intraocular lens implantation in patients with proliferative diabetic retinopathy (proliferative diabetic retinopathy). Methods: from March 2009 to March 2011, 45 patients (52 eyes) with phacoemulsification and silicone oil injection for diabetic retinopathy treated by the same surgeon in our hospital were analyzed retrospectively. 28 female patients (35-74 years old, mean 58 years old) underwent classic three-channel vitrectomy, phacoemulsification and silicone oil injection, among which 26 patients (30 eyes) underwent silicone oil extraction and intraocular lens implantation. Among them, 4 eyes (8 eyes), 10 eyes (10 eyes), 12 eyes (12 eyes) were treated with intraocular lens implantation (22 eyes), including 3 eyes (6 eyes) and 8 eyes (8 eyes). The course of diabetic retinopathy was the shortest 4 years, the longest 24 years (mean 9.2 years). Postoperative follow-up 2 years, average 8 months. The visual acuity of patients undergoing two different procedures was observed. Results: the visual acuity of the patients undergoing silicone oil extraction and intraocular lens implantation was improved in 22 eyes (76. 6%), while that of the second IOL implantation was improved in 15 eyes. There was no significant difference in the number of eyes with improved visual acuity between the two groups (X _ 2o _ (0.08) P _ (0.995) .No serious complications occurred in 52 eyes. Intraocular photocoagulation was performed during iatrogenic retinal rupture, and intraoperative bleeding was stopped by intraocular photocoagulation or increased perfusion bottle during operation. Conclusion: in vitreous surgery of proliferative retinopathy, silicone oil extraction intraocular lens implantation and secondary intraocular lens implantation can improve the visual acuity of most of the patients, but there is no significant difference between the two kinds of postoperative visual acuity.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R779.66

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