玻璃体积血的病因分析及手术治疗的疗效

目的：探讨玻璃体积血的病因及行玻璃体切割术治疗的临床疗效。

方法：对162例173眼玻璃体积血患者进行病因分析，采用玻璃体切割术治疗。

结果：术后诊断：173眼中增殖期糖尿病视网膜病变83眼(48.0%)，视网膜分支静脉阻塞24眼(13.9%)，Eales病13眼(7.5%)，视网膜中央静脉阻塞10眼(5.8%)，外伤性玻璃体积血9眼(5.2%)，视网膜裂孔8眼(4.6%)，视网膜脱离9眼(5.2%)，增生性玻璃体视网膜病变7眼(4.0%)，单纯玻璃体积血4眼(2.3%)，视网膜大动脉瘤2眼(1.2%)，息肉样脉络膜血管病变2眼(1.2%)，脉络膜视网膜炎1眼(0.6%)，年龄相关性黄斑病变1眼(0.6%)。不同年龄病因分布不同，术后随访3～15mo，术前与术后视力相比，41眼(23.7%)视力不变，115眼(66.5%)视力提高，17眼(9.8%)视力下降。术后视力与术前相比差异具有统计学意义( P<0.05)。

结论：增殖期糖尿病视网膜病变、视网膜分支静脉阻塞、Eales 病是导致玻璃体积血的主要原因。玻璃体切割联合术手术并发症少，能在一定程度上提高患者视力，是治疗玻璃体积血安全有效的方法。

Analysis on the causes of vitreous hemorrhage and effects of surgical treatment

AIM: To explore the causes of vitreous hemorrhage and the clinical efficacy of vitrectomy in vitreous hemorrhage.

METHODS:Totally 162 patients(173 eyes)with vitreous hemorrhage who underwent vitrectomy were analyzed.

RESULTS: Postoperative diagnosis: in 173 eyes, proliferative diabetic retinopathy 83 eyes(48.0%), branch retinal vein occlusion 24 eyes(13.9%), Eales disease 13 eyes(7.5%), central retinal vein occlusion 10 eyes(5.8%), traumatic vitreous hemorrhage 9 eyes(5.2%), retinal hole 8 eyes(4.6%), retinal detachment 9 eyes(5.2%), proliferative vitreoretinopathy 7 eyes(4.0%), pure vitreous hemorrhage 4 eyes(2.3%), retinal artery aneurysm 2 eyes(1.2%), polypoid choroidal vasculopathy 2 eyes(1.2%), chorioretinitis 1 eye(0.6%), age-related macular degeneration 1 eye(0.6%). Different causes were distributed in different ages, postoperative follow-up 3-15mo, visual acuity after treatment was compared with that before treatment, unchanged 41 eyes(23.7%), improved 115 eyes(66.5%), decreased 17 eyes(9.8%). Compared with the preoperative visual acuity difference was statistically significant(P<0.05).

CONCLUSION:Proliferative diabetic retinopathy, retinal vein occlusion and Eales disease are the main causes of vitreous hemorrhage. To some extent, vitrectomy surgery has a little complications and it can improve visual acuity. Vitreous hemorrhage is a safe and effective treatment method.