玻璃体手术联合曲安奈德治疗对糖尿病性黄斑水肿患者视网膜厚度、视力水平及术后并发症的影响

The effects of vitreous surgery combined with triamcinolone acetonide on retinal thickness,visual acuity level and postoperative complications in patients with diabetic macular edema

目的探讨玻璃体手术联合联合曲安奈德治疗对糖尿病性黄斑水肿(DME)患者视网膜厚度、视力水平及术后并发症的影响。方法将收治的112例DME患者(112眼)采用随机数表法分为观察组和对照组各56例。两组均予玻璃体切割术,观察组在此基础上增加曲安奈德注射。治疗前、治疗1月及6月时,评估两组视力、黄斑中心凹厚度、眼压,记录两组并发症发生率。结果①治疗1、6月后,两组BCVA均较治疗前升高(P<0.05),观察组各时间点BVCA水平均高于对照组(P<0.05);②治疗1、6月后,两组黄斑中心凹厚度均较治疗前降低(P<0.05),观察组各时间点黄斑中心凹厚度均低于对照组(P<0.05);③治疗1、6月后,两组眼压水平对比差异无统计学意义(P>0.05),且存在组间和时间的交互效应(P>0.05),两组眼压时间效应差异有统计学意义(P<0.05)。简单效应分析显示观察组组内各时间点对比差异有统计学意义(P<0.05),对照组组内各时间点对比差异无统计学意义(P>0.05),观察组治疗1月后眼压水平高于对照组(P<0.05);④两组并发症发生率对比差异均无统计学意义(P>0.05)。结论玻璃体手术联合曲安奈德治疗DME可提高患者临床疗效,但有术后眼压升高风险。

Objective To explore the effects of vitreous surgery combined with triamcinolone acetonide on retinal thickness,visual acuity level and postoperative complications in patients with diabetic macular edema(DME).Methods One hundred and twelve patients with DME(112 eyes)were divided into observation or control group according to the random number table method,56 in each group.The two groups were treated with vitrectomy,and the observation group was added with triamcinolone acetonide injection on this basis.Before treatment and after 1 month and 6 months of treatment,the visual acuity,central macular foveal thickness and intraocular pressure were evaluated,and the incidence rate of complications was recorded in the two groups.Results After 1 month and 6 months of treatment,the BCVA in the two groups was higher than that before treatment(P<0.05),and the BVCA level in the observation group was higher than that in the control group at each time point(P<0.05).After 1 month and 6 months of treatment,the central macular foveal thickness in the two groups was lower than that before treatment(P<0.05),and the central macular foveal thickness in the observation group was lower than that in the control group at each time point(P<0.05).After 1 month and 6 months of treatment,there was no significant difference in the intraocular pressure level between the two groups(P>0.05),and there were interaction effects of between groups and times(P>0.05),and there were statistically significant differences in the time effects of intraocular pressure between the two groups(P<0.05).Simple effects analysis showed that there were statistically significant differences in the observation group at different time points(P<0.05),and there were no significant differences in the control group at different time points(P>0.05),and the intraocular pressure level in the observation group after 1 month of treatment was higher than that in the control group(P<0.05).There was no significant difference in the incidence rate of complications between the two groups(P>0.05).Conclusion Vitreous surgery combined with triamcinolone acetonide for DME can improve the clinical efficacy of patients,but it has a risk of postoperative intraocular pressure increase.