玻璃体切割手术联合全视网膜光凝术治疗糖尿病视网膜病变的效果分析

Effect of pars plana vitrectomy combined with total retinal photocoagulation on diabetes retinopathy

目的分析玻璃体切割手术(PPV)联合全视网膜光凝术(PRP)治疗糖尿病视网膜病变(DR)的临床效果。方法抽取周口市中心医院2018年6月至2021年6月收治的DR患者306例,按随机数字表法将其分为PPV组与PRP组,每组153例。PRP组采用PRP治疗,PPV组采用PPV联合PRP治疗。比较两组视力恢复率、光敏度、最小分辨角对数最佳矫正视力(LogMAR BCVA)、眼底荧光血管造影分级及并发症发生率。结果PPV组视力恢复率(97.39%,149/153)高于PRP组(83.01%,127/153),P<0.05;PPV组周边30度、60度光敏度高于PRP组(P<0.05);术后1、3、6个月,PPV组LogMAR BCVA水平高于PRP组(P<0.05);术后3、6个月,PPV组眼底荧光血管造影分级优于PRP组(P<0.05);PPV组并发症发生率低于PRP组(P<0.05)。结论DR患者采用PPV联合PRP治疗,可改善视力水平和光敏度,减少微血管动脉瘤数量,改善眼底荧光血管造影分级,并可降低并发症发生率。

Objective To analyze the clinical effect of pars plana vitrectomy(PPV)combined with panretinal photocoagulation(PRP)in the treatment of diabetic retinopathy(DR).Methods A total of 306 DR patients treated in Zhoukou Central Hospital from June 2018 to June 2021 were selected,and they were divided into PPV group and PRP group by random number table method,with 153 cases in each group.The PRP group was treated by PRP,and the PPV group was treated by PPV combined with PRP.The visual acuity recovery rate,photosensitivity,best corrected visual acuity(BCVA)LogMAR,fundus fluorescein angiography classification,and complication rate were compared between the two groups.Results The visual acuity recovery rate of the PPV group was 97.39%(149/153),which was higher than that of the PRP group(83.01%,127/153),P<0.05.The 30 degree and 60 degree photosensitivity of the PPV group were higher than those of the PRP group(P<0.05).The level of LogMAR BCVA in the PPV group was higher than that in the PRP group 1,3 and 6 months after operation(P<0.05).The fundus fluorescein angiography classification in the PPV group was better than that in the PRP group 3 and 6 months after operation(P<0.05).The incidence of complications in the PPV group was lower than that in the PRP group(P<0.05).Conclusions The treatment of DR patients with PPV combined with PRP can improve visual acuity and photosensitivity,reduce the number of microvascular aneurysms,improve the fundus fluorescein angiography classification,and reduce the incidence of complications.