增殖性糖尿病视网膜病变的玻璃体切除手术治疗(1)
[摘要] 目的 探讨增殖性糖尿病视网膜病变的玻璃体切除手术的疗效。 方法 选取2012年1月～2014年1月，我院应用玻璃体切除手术治疗增殖性糖尿病视网膜病变患者20例(26眼)。术后随诊1年，观察患者的视力、眼压、晶状体、玻璃体腔、视网膜及填充物情况并处理并发症。 结果 术后随访6个月视力提高率达73.1%，其中IV期14眼，V期3眼，VI期2眼。术后随访1年视力提高率达100.0%，无一例出现视力下降。术后1年的视力提高率显著高于术后6个月视力提高率，差异有统计学意义(P<0.05)。26眼术后的视力较术前显著改善，差异有统计学意义(P<0.05)。 结论 玻璃体切除手术治疗增殖性糖尿病视网膜病变可以显著提高患者视力，并发症少，值得推广和应用。
[关键词] 玻璃体切除手术；增殖性糖尿病视网膜病变；视力；并发症
[中图分类号] R779.6 [文献标识码] B [文章编号] 2095-0616(2015)14-195-03
Vitrectomy for proliferative vitreoretinopathy
LAI Jiangfeng
Department of Ophthalmology， Meizhou People's Hospital， Meizhou 514031， China
[Abstract] Objective To explore the curative effect of vitrectomy for proliferative vitreoretinopathy. Methods 20 patients (26 eyes) who were received vitrectomy for proliferative vitreoretinopathy from January 2012 to January 2014 in our hospital were seleted. In the one-year postoperative follow-up， visual acuity， intraocular pressure， lens， vitreous cavity， retinal and the filling condition of patients were compared and complications were treated. Results In the postoperative follow-up， the improving rate of vision acuity 6 months after the treatment was 73.1%， including 14 eyes in stage IV， 3 eyes in stage V and 2 eyes in stage VI. In the postoperative follow-up， the improving rate of vision acuity 1 year after the treatment was 100.0% and no patient was with hypopsia. The improving rate of vision acuity 1 year after the treatment was significantly higher than which was 6 months after the treatment and the difference was statistically significant (P<0.05). Postoperative visual acuity of 26 eyes were significantly improved after the treatment and the difference has a statistical significance (P<0.05). Conclusion Vitrectomy for proliferative vitreoretinopathy can significantly improve visual acuity and it has few complications， which is worth promotion and application.
[Key words] Vitrectomy； Proliferative vitreoretinopathy； Visual acuity； Complications
近年来，随着人们生活水平的提高，我国糖尿病的发病率逐年呈上升趋势。糖尿病视网膜病变(diabetic retinopathy，DR)是糖尿病( diabetes mellitus，DM)最常见的微血管并发症，严重影响患者的视功能，晚期可导致不可逆性盲，其中增殖性糖尿病视网膜病变(proliferative diabetic retinopathy，PDR)是DM患者致盲的主要原因[1]。玻璃体积血、视网膜脱离和继发性青光眼是增殖性糖尿病视网膜病变患者视力丧失的主要原因。现代玻璃体切除术可以清除增殖性糖尿病视网膜病变引起的玻璃体积血、松解玻璃体对视网膜的牵拉、清除视网膜表面增殖膜及新生血管膜、封闭视网膜裂孔、复位脱离的视网膜，从而改善患者视功能[2]。2012年1月～2014年1月，我院应用玻璃体切除手术治疗增殖性糖尿病视网膜病变20例(26
眼)，取得了较好的效果，现报道如下。
1 资料与方法
1.1 一般资料
选择本院2012年1月～2014年1月收治的增殖性糖尿病视网膜病变患者20例(26眼)，男12例，女8例，年龄26～80岁，平均(56.1±6.3)岁。糖尿病病程最短9年，最长16年，其中1型糖尿病2例(4眼)，2型糖尿病18例(22眼)；纳入标准：具有正常的理解能力和语言能力。排除精神病史或者神经病史的患者、合并其他系统严重疾病的患者。根据1985年第一届全国眼底病会议制订的糖尿病视网膜病变分型分期标准分为Ⅳ期16眼，Ⅴ期5眼，Ⅵ期5眼。术前视力：光感至0.2。眼压均在正常范围，其中合并不同程度的玻璃体积血12眼。, http://www.100md.com(赖江峰)
[关键词] 玻璃体切除手术；增殖性糖尿病视网膜病变；视力；并发症
[中图分类号] R779.6 [文献标识码] B [文章编号] 2095-0616(2015)14-195-03
Vitrectomy for proliferative vitreoretinopathy
LAI Jiangfeng
Department of Ophthalmology， Meizhou People's Hospital， Meizhou 514031， China
[Abstract] Objective To explore the curative effect of vitrectomy for proliferative vitreoretinopathy. Methods 20 patients (26 eyes) who were received vitrectomy for proliferative vitreoretinopathy from January 2012 to January 2014 in our hospital were seleted. In the one-year postoperative follow-up， visual acuity， intraocular pressure， lens， vitreous cavity， retinal and the filling condition of patients were compared and complications were treated. Results In the postoperative follow-up， the improving rate of vision acuity 6 months after the treatment was 73.1%， including 14 eyes in stage IV， 3 eyes in stage V and 2 eyes in stage VI. In the postoperative follow-up， the improving rate of vision acuity 1 year after the treatment was 100.0% and no patient was with hypopsia. The improving rate of vision acuity 1 year after the treatment was significantly higher than which was 6 months after the treatment and the difference was statistically significant (P<0.05). Postoperative visual acuity of 26 eyes were significantly improved after the treatment and the difference has a statistical significance (P<0.05). Conclusion Vitrectomy for proliferative vitreoretinopathy can significantly improve visual acuity and it has few complications， which is worth promotion and application.
[Key words] Vitrectomy； Proliferative vitreoretinopathy； Visual acuity； Complications
近年来，随着人们生活水平的提高，我国糖尿病的发病率逐年呈上升趋势。糖尿病视网膜病变(diabetic retinopathy，DR)是糖尿病( diabetes mellitus，DM)最常见的微血管并发症，严重影响患者的视功能，晚期可导致不可逆性盲，其中增殖性糖尿病视网膜病变(proliferative diabetic retinopathy，PDR)是DM患者致盲的主要原因[1]。玻璃体积血、视网膜脱离和继发性青光眼是增殖性糖尿病视网膜病变患者视力丧失的主要原因。现代玻璃体切除术可以清除增殖性糖尿病视网膜病变引起的玻璃体积血、松解玻璃体对视网膜的牵拉、清除视网膜表面增殖膜及新生血管膜、封闭视网膜裂孔、复位脱离的视网膜，从而改善患者视功能[2]。2012年1月～2014年1月，我院应用玻璃体切除手术治疗增殖性糖尿病视网膜病变20例(26
眼)，取得了较好的效果，现报道如下。
1 资料与方法
1.1 一般资料
选择本院2012年1月～2014年1月收治的增殖性糖尿病视网膜病变患者20例(26眼)，男12例，女8例，年龄26～80岁，平均(56.1±6.3)岁。糖尿病病程最短9年，最长16年，其中1型糖尿病2例(4眼)，2型糖尿病18例(22眼)；纳入标准：具有正常的理解能力和语言能力。排除精神病史或者神经病史的患者、合并其他系统严重疾病的患者。根据1985年第一届全国眼底病会议制订的糖尿病视网膜病变分型分期标准分为Ⅳ期16眼，Ⅴ期5眼，Ⅵ期5眼。术前视力：光感至0.2。眼压均在正常范围，其中合并不同程度的玻璃体积血12眼。, http://www.100md.com(赖江峰)