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灌注液填充微创玻璃体视网膜手术治疗增殖性糖尿病视网膜病变的疗效观察 被引量:1

Observation of efficacy of minimally invasive vitreoretinal surgery with perfusion filling in the treatment of proliferative diabetic retinopathy
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摘要 目的 观察灌注液填充微创玻璃体视网膜手术治疗增殖性糖尿病视网膜病变(PDR)的临床疗效。方法 47例(56眼)PDR患者,均接受灌注液填充微创玻璃体视网膜手术治疗。观察术后患者最佳矫正视力(BCVA)、术后体位、舒适度,视网膜复位以及术后并发症发生情况。结果 术后,患者平均BCVA为(1.07±0.84)LogMAR,明显优于术前的(1.58±0.90)LogMAR,差异具有统计学意义(P<0.05)。其中BCVA指数以下5眼(8.9%);指数~0.1 14眼(25.0%);0.1~0.3 21眼(37.5%);≥0.316眼(28.6%);患眼视力>0.1所占比例由术前25.0%提高到术后的66.1%。术后视力不同程度提高42眼,占75.0%;其中视力提高>2行31眼,占55.4%;视力不变10眼,占17.9%;视力较术前下降4眼,占7.1%。PDRⅣ期患者术后视力改善17眼,无显著变化0眼,下降1眼;Ⅴ期患者术后视力改善21眼,无显著变化4眼,下降1眼;Ⅵ期患者术后视力改善4眼,无显著变化6眼,下降2眼。视网膜一次性复位7眼,复位率为12.5%(7/56);视网膜未复位或术后出现复发性视网膜脱离2眼(3.6%)。随访末期,所有患者视网膜均持续保持在位状态,最终视网膜复位率达100.0%。结论 灌注液填充微创玻璃体视网膜手术治疗PDR患者安全有效,且不增加术后并发症,同时术后视力恢复快,可获得理想的远期疗效,值得临床广泛推广。 Objective To observe the clinical efficacy of minimally invasive vitreoretinal surgery with perfusion filling in the treatment of proliferative diabetic retinopathy(PDR). Methods 47 patients(56 eyes) with PDR received minimally invasive vitreoretinal surgery with perfusion filling. The best corrected visual acuity(BCVA), postoperative posture, comfort, retinal reattachment and postoperative complications were observed.Results After surgery, the average BCVA of patients was(1.07±0.84) LogMAR, which was significantly better than(1.58±0.90) LogMAR before surgery, and the difference was statistically significant(P<0.05). Among them, BCVA was worse than finger counting in 5 eyes(8.9%), worse than 0.1 in 14 eyes(25.0%), 0.1-0.3 in 21 eyes(37.5%), ≥0.3 in 16 eyes(28.6%);the proportion of eyes with visual acuity >0.1 increased from 25.0%before surgery to 66.1 % after surgery. The postoperative visual acuity improved in 42 eyes, accounting for 75.0%;among them, the visual acuity improved >2 lines in 31 eyes, accounting for 55.4%;the visual acuity remained unchanged in 10 eyes, accounting for 17.9%;the visual acuity decreased compared with the preoperative visual acuity in 4 eyes, accounting for 7.1%. Stage Ⅳ PDR patients had postoperative visual acuity improvement in 17 eyes, no significant change in 0 eye, and decline in 1 eye;stage Ⅴ patients had postoperative visual acuity improvement in 21 eyes, no significant change in 4 eyes;and decline in 1 eye;stage Ⅵ patients had postoperative visual acuity improvement in 4 eyes, no significant change in 6 eyes, and decline in 2 eyes. 7 eyes had onetime retinal reattachment, the reattachment rate was 12.5%(7/56);2 eyes(3.6%) had no retinal reattachment or recurrent retinal detachment after surgery. At the end of follow-up, the retinas of all patients remained in place,and the final retinal reattachment rate reached 100.0%. Conclusion Minimally invasive vitreoretinal surgery with perfusion filling is safe and effective in the treatment of patients with PDR, and does not increase postoperative complications, while the rapid recovery of postoperative visual acuity and can achieve ideal long-term results,which is worthy of wide clinical promotion.
作者 徐嘉阳 XU Jia-yang(Dalian Third People's Hospital,Dalian 116600,China)
出处 《中国实用医药》 2022年第18期93-95,共3页 China Practical Medicine
关键词 增殖性糖尿病视网膜病变 微创玻璃体视网膜手术 灌注液填充 Proliferative diabetic retinopathy Minimally invasive vitreoretinal surgery Perfusion filling
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