视网膜脱离术后复发的影响因素分析

Analysis of factors influencing the postoperation recurrence of retinal detachment

目的探讨视网膜脱离术后复发的影响因素。方法选择2018年1月—2022年1月在医院行视网膜脱离术的587例患者为调查对象,将其中术后复发的52例患者纳入复发组(病例组);未复发的535例患者纳入未复发组(对照组)。通过单因素和多因素Logistic回归分析,筛选视网膜脱离术后复发的危险因素。结果单因素分析结果显示,复发组男性、合并糖尿病、孔源性视网膜脱离伴增生性玻璃体视网膜病变(PVR)、术前PVR分级>C级、下方裂孔、视网膜脱离手术次数≥2次、术后残留玻璃体皮质、术后眼底出血占比均高于未复发组,组间差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,合并糖尿病、孔源性视网膜脱离伴PVR、术前PVR分级>C级、下方裂孔、视网膜脱离手术次数≥2次、术后残留玻璃体皮质、术后眼底出血是视网膜脱离术后复发的影响因素(P<0.05)。结论合并糖尿病、孔源性视网膜脱离伴PVR、术前PVR分级>C级、下方裂孔、视网膜脱离手术次数≥2次、术后残留玻璃体皮质、术后眼底出血均是视网膜脱离术后复发的危险因素。

Objective To explore the influencing factors of recurrence after retinal detachment.Methods 587 patients who underwent retinal detachment surgery in the hospital from January 2018 to January 2022 were selected as investigation subjects,and 52 of them with postoperative recurrence were included in the recurrence group(case group),535 patients without recurrence were included in the non-recurrence group(control group).Risk factors for postoperative recurrence of retinal detachment were screened by unifactorial and multifactorial logistic regression analyses.Results The results of univariate analysis showed that the percentages of male,combined diabetes mellitus,foramen ovale retinal detachment with proliferative vitreoretinopathy(PVR),preoperative PVR grading>level C,fi ssure underneath,retinal detachment surgery≥2 times,postoperative residual vitreous cortex,and postoperative fundus haemorrhage were higher in recurrent group than in the non-recurrent group,and the diff erence was statistically significant between the groups(P<0.05).The results of multifactorial logistic regression analysis showed that the combination of diabetes mellitus,foramen ovale retinal detachment with PVR,preoperative PVR>level C,fi ssure underneath,the number of retinal detachment surgeries≥2 times,postoperative residual vitreous cortex,and postoperative fundus haemorrhage were the influencing factors of postoperative recurrence after retinal detachment(P<0.05).Conclusion Combined diabetes mellitus,foramen ovale retinal detachment with PVR,preoperative PVR grading>level C,below fissure,number of retinal detachment surgeries≥2 times,postoperative residual vitreous cortex,and postoperative fundus haemorrhage were risk factors for postoperative retinal detachment recurrence.