玻璃体切除联合曲安奈德玻璃体注射治疗增殖期糖尿病视网膜病变的临床观察

Clinical observation of vitrectomy combining with intravitreal injection of triamcinolone acetonide in the treatment of diabetic retinopathy at proliferating phase

目的观察玻璃体切除联合曲安奈德玻璃体注射治疗增殖期糖尿病视网膜病变的临床疗效。方法选取我院2013年1月~2014年1月确诊的增殖期糖尿病视网膜病变70例患者,术前均行矫正视力、眼压、眼底及B超检查,随机分为观察组与对照组,每组各35例,对照组行常规玻璃体切除术,观察组行玻璃体切除联合曲安奈德玻璃体注射治疗。比较两组患者术后黄斑水肿发生率及平均眼压、视力改善情况。结果观察组的黄斑水肿发生率（14.4%）显著低于对照组的（31.4%）,差异有统计学意义（P〈0.05）,但观察组与对照组的平均眼压比较,差异无统计学意义（P〉0.05）。观察组患者视力改善率为65.7%（23/35）,对照组患者视力改善率为42.8%（15/35）,观察组患者视力改善率显著高于对照组,差异有统计学意义（P〈0.05）。结论玻璃体切除术中应用曲安奈德具有较好的疗效,能显著改善患者的视力,且并发症少,值得推广和应用。

Objective To observe the clinical effect of vitrectomy combining with intravitreal injection of triamcinolone acetonide in the treatment of diabetic retinopathy at proliferating phase. Methods From January 2013 to January2014,70 patients who were definitely diagnosed as proliferative diabetic retinopathy in our hospital were selected.The corrected visual acuity,and examinations of intraocular pressure,ocular fundus examination and B ultrasound were applied before surgery.They were evenly divided into observation group and control group in random.In the control group,conventional vitrectomy was used,while in the observation group,vitrectomy combining with intravitreal injection of triamcinolone acetonide was adopted.The incidence of macular oedema,average intraocular pressure,and vision improvement after surgery were compared in the two groups. Results The incidence of macular edema（14.4%） in the observation group was significantly lower than that（31.4%） in the control group with a statistical difference（P〈0.05）.There was no great difference in average intraocular pressure in both groups（P〉0.05）.In the observation group,the rate of vision improvement was 65.7%（23/35）,while in the control group,the rate was 42.8%（15/35）.The rate of vision improvement in the observation group was much higher than that in the control group,which was displayed a statistical difference（P〈0.05）. Conclusion Application of triamcinolone acetonide in vitrectomy can obtain a good effect,and remarkably improve patient′s vision with few complications,which is worthy of promotion and application.