摘要
目的探讨玻璃体切割术联合曲安奈德治疗糖尿病性黄斑水肿的黄斑区变化。方法采用前瞻性研究方法,选择2013年12月至2016年4月在我院诊治的糖尿病性黄斑水肿患者142例(142眼),根据信封随机抽签法分为观察组与对照组,各71例,对照组给予玻璃体切割术,观察组在玻璃体切割术术前5~7 d应用曲安奈德注射治疗,记录两组视力与黄斑区变化。结果术后1个月观察组与对照组的视力明显好于术前(P<0.05),观察组术后1个月视力明显好于对照组(P<0.05)。观察组与对照组术后1个月的黄斑中心凹厚度分别为(168.34±22.19)、(267.35±34.11)μm,均明显低于术前的(516.35±45.20)、(522.14±23.01)μm(P<0.05),观察组明显低于对照组(P<0.05)。观察组术后1个月玻璃体积血、新生血管性青光眼、瞳孔区膜性渗出等并发症发生率为8.5%,对照组为9.6%,两组比较差异无统计学意义(P>0.05)。结论玻璃体切割术联合曲安奈德治疗糖尿病性黄斑水肿能减轻黄斑水肿,缩小黄斑区域,从而促进术后视力的提高,且具有很好的安全性。
Objective To investigate the macular changes after vitrectomy combined with triamcinolone acetonide in the treatment of diabetic macular edema.Methods Totally 142 diabetic macular edema patients（142 eyes）in our hospital for diagnosis and treatment from December 2013 to April 2016 were selected.They were divided into observation group and control group randomly,with 71 cases in each group,according to the envelope method.Control group was treated with vitrectomy,and observation group was given triamcinolone acetonide injection at 5~7 d before operation.The visual acuity and macular changes were recorded.Results The visual acuity of the patientsin treatment group and control group was improved at 1 month after operation（P0.05）,and there were significant difference between the two groups（P0.05）.At 1 month after operation,the foveal thickness in observation group[（516.35 ±45.20） μm vs.（168.34 ± 22.19） μm]and control group[（522.14 ± 23.01） μm vs.（267.35 ± 34.11） μm]decreased significantly（P0.05）,and the foveal thickness in observation group was lower than that of control group（P0.05）.The incidence rates of vitreous blood,new blood vessel glaucoma and pupil in observation group and control group were 8.5%and 9.6%（P0.05）.Conclusion Vitrectomy combined with triamcinolone acetonide in the treatment of diabetic macular edema can reduce macular edema,promote the improvement of postoperative visual acuity with good security.
出处
《实用药物与临床》
CAS
2017年第3期300-303,共4页
Practical Pharmacy and Clinical Remedies
基金
海南省卫生厅医学科研立项课题(琼卫2012PT-28)
