术前注射雷珠单抗对糖尿病视网膜病变伴血管性青光眼患者的治疗效果及安全性研究

Study on the efficacy and safety of preoperative injection of razumab in patients with diabetic retinopathy and neovascular glaucoma

目的探究术前注射雷珠单抗对糖尿病视网膜病变(diabetic retinopathy,DR)伴血管性青光眼(neovascular glaucoma,NVG)患者的治疗效果及安全性。方法选择2017年7月—2019年6月在绍兴市人民医院接受治疗的DR伴NVG患者80例为研究对象,根据治疗方案的不同分为观察组(44例)和对照组(36例)。对照组患者采用玻璃体切割术(pars-plana vitrectomy,PPV)进行治疗,观察组在对照组的基础上联合术前注射雷珠单抗进行治疗,比较2组患者的临床手术情况,包括手术时间、术中出血次数及电凝次数;检测比较2组患者术前、PPV术后1周、Ⅱ期手术术后1个月的最佳矫正视力(best corrected visual acuity,BCVA)与眼压,以及Ⅱ期Ahmed房水引流阀植入术后1个月的黄斑中心凹视网膜厚度;比较2组患者PPV手术并发症发生率。结果观察组患者的手术时间、术中出血次数、电凝次数均明显低于对照组(均P<0.05);PPV术后1周、Ⅱ期手术术后1个月观察组患者的BCVA、眼压水平明显低于对照组(均P<0.05);观察组患者Ⅱ期Ahmed房水引流阀植入术后1个月的黄斑中心凹视网膜厚度为(259.42±33.78)μm,对照组为(281.64±36.97)μm,观察组明显低于对照组(P<0.05);观察组患者的术后并发症发生率为9.09%,对照组为30.56%,观察组明显低于对照组(P<0.05)。结论术前注射雷珠单抗对DR伴NVG患者具有较好的临床疗效,有利于患者术后视力和眼压的恢复,减少了对视网膜的损伤,具有较高的安全性。

Objective To explore the efficacy and safety of preoperative injection of razumab in patients with diabetic retinopathy(DR)and neovascular glaucoma(NVG).Methods A total of 80 patients with DR and NVG who were treated in our hospital from July 2017 to June 2019 were selected as the study subjects,they were divided into observation group(44 cases)and control group(36 cases)according to different treatment schemes.The control group was treated with pars-plana vitrectomy(PPV),while the observation group was treated with preoperative injection of razumab on the basis of the control group.The clinical operation conditions of the two groups were compared,including the operation time,intraoperative bleeding times and electrocoagulation times;the best corrected visual acuity(BCVA)and intraocular pressure were measured and compared before operation,1 week after PPV,1 month after stageⅡsurgery,and stageⅡ.The macular foveal retinal thickness was measured one month after Ahmed aqueous humor drainage valve implantation.The incidence of PPV complications was compared between the two groups.Results The operation time,bleeding times and electrocoagulation times in the observation group were significantly lower than those in the control group(all P<0.05).The levels of BCVA and intraocular pressure in the observation group were significantly lower than those in the control group one week after PPV operation and one month after stageⅡoperation(all P<0.05).The thickness of the macular foveal retina in the observation group was(259.42±33.78)m one month after the stageⅡAhmed aqueous drainage valve implantation,and the control group was(281.64±36.97)m,the observation group was significantly lower than that in control group(P<0.05).The incidence of postoperative complications in the observation group was 9.09%,and that in the control group was 30.56%,the observation group was significantly lower than that in control group(P<0.05).Conclusion Preoperative injection of razumab has a good clinical effect on DR patients with NVG,which is conducive to the recovery of visual acuity and intraocular pressure after operation,and reduces the damage to retina,and has high safety.