增生型糖尿病视网膜病变患者玻璃体切割术后玻璃体再积血的影响因素分析

Influencing factors of vitreous hemorrhage after pars plana vitrectomy in patients with proliferative diabetic retinopathy

目的探讨增生型糖尿病视网膜病变(PDR)患者玻璃体切割手术(PPV)后发生玻璃体再积血(PVH)的影响因素。方法回顾性分析2017年1月至2020年12月烟台业达医院眼科收治的210例实施PPV治疗的PDR患者的临床资料,统计患者术后PVH的发生率。经单因素及多因素回归分析找出PDR患者PPV后发生PVH的影响因素。结果210例PDR患者PPV后发生PVH 40例,占19.05%。Logistic回归分析结果显示,术前未进行玻璃体腔注药(抗血管内皮生长因子药物)、合并增生视网膜牵引、临床分期Ⅵ期、术后眼压水平高、术前糖化血红蛋白水平高是PDR患者PPV后发生PVH的影响因素(OR>1,P<0.05)。结论术前未进行玻璃体腔注药、合并增生视网膜牵引、临床分期Ⅵ期、术后眼压水平高、术前糖化血红蛋白水平高是PDR患者PPV后发生PVH的影响因素。

Objective To investigate the influencing factors of postoperative vitreous hemorrhage(PVH)in patients with proliferative diabetic retinopathy(PDR)after pars plana vitrectomy(PPV).Methods The clinical data of 210 patients with PDR treated by PPV in Yantai Yeda Hospital from January 2017 to December 2020 were retrospectively analyzed.The occurrence rate of PVH after PPV were consulted.The influencing factors of PVH after PPV in PDR patients were identified by univariate and multivariate regression analysis.Results PVH occurred in 40 of 210 PDR patients after PPV,accounting for 19.05%.Results of Logistic regression analysis showed that no preoperative intravitreal injection(anti vascular endothelial growth factor drugs),combined with proliferative retinal traction,clinical stage VI,high postoperative intraocular pressure and high preoperative glycosylated hemoglobin level were the influencing factors of PVH after PPV in PDR patients(OR>1,P<0.05).Conclusions The no intravitreal injection before operation,combined with proliferative retinal traction,clinical stage VI,high intraocular pressure level after operation,and high glycosylated hemoglobin level before operation are influencing factors of PVH after PPV in patients with PDR.