复合式玻璃体视网膜手术治疗增殖型糖尿病视网膜病变疗效分析.docVIP

复合式玻璃体视网膜手术治疗增殖型糖尿病视网膜病变疗效分析 　【摘要】 目的 回顾性分析复合式玻璃体视网膜手术治疗增殖型糖尿病视网膜病变（proliferative diabetic retinopathy，PDR）的临床效果。方法 收住院的PDR患者272例338眼中男126例156眼，女146例182眼，年龄34～76岁，平均55岁，在控制血糖、血压平稳的情况下均实施了复合式玻璃体视网膜手术治疗，分析住院期间手术前后的病历资料，对不同分期的患者手术前后视力进行分析，找出近期影响手术疗效的因素。结果 88.6%的患眼手术后视力获得不同程度的改善，PDR的严重程度、继发性玻璃体出血和16%C3F8填充或硅油填充都对术后近期视力有较大影响，术后近期玻璃体再出血的患者及时行玻璃体切除，寻找出血原因，并予以处理。结论 采用复合式玻璃体视网膜手术治疗PDR是能够维护视功能、提高视力唯一有效的治疗途径。早期明确诊断及分期、正确掌握手术适应证的选择和手术时机、改善手术技巧、避免并发症，才能获得较好术后视功能的恢复。 【关键词】 复合式玻璃体视网膜手术；增殖型糖尿病视网膜病变；疗效分析 ［Abstract］ Objective To analyse retrospectively the clinical effect of vitreoretinal surgery on the treatment of proliferative diabetic retinopathy.Methods Two hundred and seventy-two patients (338 eyes) in hospital，including 126 males (156 eyes) and 146 females (182 eyes)，whose age rang from 34 to 76 years old，mean 55 years old，were operated vitreoretinal surgery after controlling blood sugar and blood pressure.To analyse the patients materials pre- and post-operation during hospital and pre- and post-operative eyesight of patients in different teams and find out the influent factors on the operative effect.Results 88.6% of patients were progressive to different extent after operation.There are some factors that affect the postoperative eyesight in the near future，including the degree of proliferative diabetic retinopathy，secondary vitreous hemorrhage，the filling of 16% C3F8 or silicon oil.The patients with vitreous re-hemorrhage in the near future were timely operated the extraction of vitreous body，treated the hemorrhage.Conclusion The vitreoretinal surgery is the only effective method of protecting eyefunction and promoting eyesight on proliferative diabetic retinopathy.By the early diagnosis and stage，correct choice of operative adaptive diseases and operative stage，promoting operative technology and preventing complications，the postoperative eyesight will be well promoted. ［Key words］ vitreoretinal surgery；proliferative diabetic retinophy；the analysis on effect 糖尿病是一种全球性疾病