玻璃体腔内注射康柏西普联合玻璃体切割及全视网膜光凝治疗糖尿病性视网膜病变

Clinical Effect of Joint Application of Intravitreal Injection of Compactin and Total Retinal Photocoagulation in Treating Diabetic Retinopathy Photocoagulation in Treating Diabetic Retinopathy

目的探究玻璃体腔内注射康柏西普、玻璃体切割术联合全视网膜光凝治疗糖尿病性视网膜病变的临床效果。方法选取2018年1月至2018年6月,糖尿病性视网膜病变患者80例,采用随机数字法均等分组,对照组患者40例,给予行玻璃体切割及全视网膜光凝术;观察组患者40例,给予玻璃体腔内注射康柏西普、玻璃体切割术联合全视网膜光凝治疗,比较两组患者视力、生活质量、视网膜厚度等指标变化。结果观察组手术时间(72. 9±8. 5)min明显较对照组短(98. 7±12. 6)min,差异具有统计学意义(P<0. 05);观察组术后玻璃体再出血发生率、医源性裂孔、术中出血、术中打油眼数少于对照组(P<0. 05);两组患者术中打气眼数比较,差异无统计学意义(P>0. 05)。术后3个月,观察组VEGF(121. 5±36. 0)g/L明显低于对照组(198. 6±52. 7)g/L;观察组视网膜厚度(179. 9±53. 7)μm薄于对照组(264. 6±62. 6)μm;观察组最佳矫正视力(Best corrected visual acuity,BCVA)(0. 26±0. 1)高于对照组(0. 19±0. 1),差异具有统计学意义(P<0. 05)。观察组患者生活质量各维度评分均较对照组高(P<0. 05)。结论玻璃体腔内注射康柏西普、玻璃体切割术联合全视网膜光凝治疗糖尿病性视网膜病变,并发症少,提高术后视力及生活质量,减轻视网膜厚度,对血管生成产生明显抑制效果、安全性,值得推广。

Objective To investigate the clinical effect of the joint application of intravitreal injection of compactin and total retinal photocoagulation in the treatment of diabetic retinopathy.Methods80 diabetic retinopathy patients treated from Jan. 2018 to Jun. 2018 were selected and divided equally and randomly into two groups:the control group and observation group. The 40 patients in the control group were treated with vitrectomy and total retinal photocoagulation,and the 40 cases in the observation group with intravitreal injection of compactin in addition. The changes to visual acuity,quality of life,retinal thickness and other indicators in the two groups were compared.Results The operation time of the observation group was much shorter than that of the control group(72. 9 vs. 98. 7)and the differences of other indicators were statistically significant(P<0. 05). In the observation group,the incidences of postoperative vitreous rebleeding,iatrogenic perforation,intraoperative bleeding and intraoperative number of oiling eyes were significantly lower than those in the control group,but the difference in the number of intraoperative air holes was not statistically significant(P>0. 05).Three months after the surgery,the VEGF in the observation group was much lower than that in the control group(121. 5 ± 35. 9 g/L vs. 198. 6 ± 52. 7 g/L),retinal thickness much thinner than that in the control group(179. 9±6. 0 g/L vs. 198. 6 ± 52. 7 g/L),and bost corrected visual acuity higher than that in the control group(0. 26±0. 1 vs. 0. 19±0. 1). All the differences were significant(P<0. 05). Before the surgery,there was no significant difference between the two groups in 8 dimensions of quality of life(P>0. 05).The scores of all dimensions of quality of life in the observation group were higher than those in the control group 3 months after the surgery,and the differences were statistically significant(P < 0. 05).Conclusions Featuring fewer complications,improved postoperative vision and quality of life,reduced retinal thickness and significantly inhibited angiogenesis, the combination of intravitreal injection of compactin, vitrectomy and total retinal photocoagulation to treat diabetic retinopathy is safe and worthy of promotion.