玻璃体腔注射UK联合TA治疗玻璃体积血的疗效观察

Efficacy observation on treatment of vitreous hemorrhage by combining the injection of UK in vitreous cavity with TA

目的:观察玻璃体腔注射尿激酶(urokinase,UK)联合曲安奈德(triamcinoloneacetonide,TA)治疗玻璃体积血的疗效和安全性。方法:回顾性分析2009-04/2011-02就诊于我院眼科,确诊为玻璃体积血的患者52例52眼,年龄29～65(平均54.2)岁,给予玻璃体腔注射尿激酶1万U(0.1mL)+TA4mg(0.1mL),治疗前后检查视力、眼压和眼底改变。所有患者随访时间超过3mo,其中14例超过16mo。结果:治疗前患眼视力均为手动～0.02,治疗有效37例(71%),其中视网膜静脉阻塞引起出血28例,治疗有效26例。糖尿病性视网膜病变引起出血20例,治疗有效9例。视网膜静脉周围炎引起出血4例,治疗有效2例。效果最佳者视力由治疗前手动提高至1.0,为视网膜静脉阻塞引起玻璃体积血患者,15例治疗后视力无变化,无视力下降者。结论:玻璃体腔注射尿激酶联合TA治疗玻璃体积血,尤其是视网膜静脉阻塞引起的玻璃体积血安全有效,值得推广。

AIM：To observe the effectiveness and safety of the treatment on vitreous hemorrhage by combining the injection of urokinase （UK） in vitreous cavity with triamcinolone acetonide （TA）.METHODS：Totally 52 cases （52 eyes） who were finally diagnosed as vitreous hemorrhage during April,2009 to February,2011 in the ophthalmology department of our hospital were analyzed retrospectively.The patients with an average age of 54.2,who aged from 29 to 65,were given the treatment of injection of UK （10000U/0.1 mL） in vitreous cavity along with TA （4mg/0.1mL）.The results showed that their vision,intraocular pressure（IOP） and ocular fundus have changed.All the patients involved were followed-up for more than 3 months,and 14 of them were followed-up for over 16 months.RESULTS：Before the treatment,the eyesight of every patient involved was hand movement to 0.02.After the treatment,the eyesight of the most effective case,who suffered from vitreous hemorrhage caused by retinal vein occlusion,was improved to 1.0.Of all the cases involved,37 （71%） were cured,26 （93%） of the 28 cases with the problem of blooding caused by retinal vein occlusion were cured,9 （45%） of the 20 cases with the problem of blooding caused by diabetic retinopathy were cured,and 2 （50%） of the 4 cases with the problem of blooding caused by retinal periphlebitis were cured.And other 15 cases were found having no difference in the eyesight after the treatment.Of the 37 effective cases,1 year later,2 cases got vitreous hemorrhage caused by retinal vein occlusion who recovered after the operation of vitrectomy,and 1 of the 37 cases,who was the patient of diabetic retinopathy,suffered from shallow retinal detachment,and he was given the retinal reattachment after the operation of vitrectomy combined with silicone oil tamponade,but his eyesight was not well recovered.None of the 52 cases suffered from the increase in IOP or endophthalmitis,etc.CONCLUSION：The treatment to vitreous hemorrhage by combining the injection of UK in vitreous cavity with TA is very effective,especially for the cure of vitreous hemorrhage caused by retinal vein occlusion,which is worth promoting.