组织型纤溶酶原激活剂、肝素和高三尖杉酯碱对术后增生性玻璃体视网膜病变的抑制作用

Suppressive effect of combination of t-PA,heparin and homoharringtonine on formation of PVR aftervetreoretinal surgery

目的 观察组织型纤溶酶原激活剂 (tissue plasminogen activator,t- PA)、肝素和高三尖杉酯碱联合用药对术后增生性玻璃体视网膜病变 (proliferative vitreoretinopathy,PVR)的抑制效果。 方法 43例 44只眼接受玻璃体视网膜手术的复杂性视网膜脱离患者 ,根据手术及是否同时球内联合用药分为 A、B两组 (A组为用药组 ,B组为对照组 )。随访观察两组术后 PVR再发生及视网膜脱离复发情况 ,平均随访期为 7.9个月。 结果 PVR发生率 :A组 15 .8% ,B组 45 .5 % ,χ2检验 ,P<0 .0 5。视网膜脱离复发率 A组5 .5 % ,B组 33.3% ,χ2检验 ,P<0 .0 5。 结论 手术辅以球内联合用药可有效抑制术后 PVR再形成 ,降低视网膜脱离复发率。

Objective To observe the suppressive effect of combination of tissue plasminogen activator(t-PA),heparin and homoharringtonine on the formation of proliferative vitreoretinopathy (PVR) after vitreoretinal surgery. Methods Forty-three cases (44 eyes)of complicated retinal detachment who receivedvitreoretinal surgery were divided into 2 groups.Twenty cases(20 eyes)in group A were treated by intravitreal injection of above mentioned drugs at the end of operation,while no intraocular injection of drugs given in 23cases(24 eyes)in group B.The mean follow-up period was 7.9 months. Result The rate of recurrent PVR in group A was 15.8%(3 of 19),and 45.5%(10 of 22) in group B (P<0.05).The rate of recurrent retinal detachment was 5.5%(1 of 18) in group A,and 33.3%(7 of 21) in group B,in group B (P<0.05). Conclusion Combination use of the above mentioned drugs can effectively suppress the postoperative recurrent PVR and lower the rate of subsequent recurrent retinal detachment.