玻璃体腔注射康柏西普联合23G玻璃体切割手术治疗增生型糖尿病视网膜病变疗效观察

目的 观察玻璃体腔注射康柏西普联合23G玻璃体切割手术治疗增生型糖尿病视网膜病变的临床效果.方法 采用回顾性非随机临床对照研究收集2014年6月至2016年6月淮安市第二人民医院收治的增生型糖尿病视网膜病变(PDR)患者76例85眼,依据术前是否行康柏西普玻璃体腔注射将患者分为联合药物治疗组和单纯手术治疗组.联合药物治疗组41眼在玻璃体切除术前5~7 d行康柏西普玻璃体腔注药0.5 mg/0.05 mL;单纯手术治疗组44眼单纯行玻璃体切除手术.对比观察两组患者手术时间、医源性裂孔、术中出血、电凝止血、填充物类型、术后玻璃体再出血以及术后6个月时的最佳矫正视力等情况.结果 联合药物治疗组的平均手术用时、医源性裂孔发生率、术中出血、应用电凝止血频率、术中硅油填充率、术后玻璃体再出血发生率及术后最佳矫正视力分别为(70.55±23.08)min、12.20%、19.51%、17.07%、34.15%、4.88%、(0.374±0.211),单纯手术治疗组分别为(99.57±28.86)min、50.0%、65.91%、43.18%、65.91%、18.18%、(0.263±0.171),两组比较差异均有统计学意义(P<0.05).结论 玻璃体腔注射康柏西普联合23G玻璃体切割手术治疗增生型糖尿病视网膜病变,能缩短手术时间,减少手术中电凝及医源性视网膜裂孔的发生率,降低硅油填充率以及手术后玻璃体再积血发生率,最终提高患眼视力.

Effect of intravitreal injection of Conbercept combined with 23G vitrectomy to treat proliferative diabetic retinopathy

Objective To observe the clinical effect of intravitreal injection of Conbercept combined with 23G vitrectomy on proliferative diabetic retinopathy (PDR). Methods A total of 76 patients (85 eyes) with PDR, who admitted to our hospital from June 2014 to June 2016, were selected by using a retrospective nonrandomized clinical controlled study and divided into the combination drug therapy group and the surgery group according to opplying in-traperitoneal injection of carbohydrate or not. The combined group (41 eyes) was treated with 0.5 mg/0.05 mL Conber-cept intravitreal injection 5-7 d before vitrectomy, and the surgery group (44 eyes) underwent direct vitrectomy. The av-erage operation time, incidence of iatrogenic retinal breaks, intraoperative hemorrhage, electric coagulation, types of tamponade, postoperative vitreous re-hemorrhage, and best corrected visual acuity of the two groups 6 months after surgery were compared. Results The average operation time, iatrogenic retinal hole, intraoperative hemorrhage, elec-tric coagulation hemostasis rate, the use of silicone oil tamponade incidence, occurrence of postoperative vitreous re-hemorrhage, and best corrected visual acuity of the combined group were (70.55 ± 23.08) min, 12.20%, 19.51%, 17.07%, 34.15%, 4.88%, respectively, which were significantly lower than corresponding (99.57 ± 28.86) min, 50.0%, 65.91%, 43.18%, 65.91%, 18.18%of the surgery group (P<0.05). The postoperative best corrected visual acuity of the combined group was (0.374±0.211), which was significantly better than (0.263±0.171) of the surgery group (P<0.05). Conclusion 23G vitrectomy combined with intravitreal injection of Conbercept can shorten surgical time, reduce the use of electric coagulation, occurrences of iatrogenic retinal breaks, use of silicon oil and postoperative recurrent vitre-ous hemorrhage, which is helpful for improving visual acuity for PDR patients finally.