玻切手术中联合曲安奈德治疗糖尿病性黄斑水肿的疗效观察.docVIP

精品论文 参考文献 玻切手术中联合曲安奈德治疗糖尿病性黄斑水肿的疗效观察 申 飞 　　开封市中心医院眼科 开封 475000 　　摘要：目的：探讨玻切手术中联合玻璃体腔注射曲安奈德（TA）治疗糖尿病性黄斑水肿（DME）的临床疗效与安全性，阐明这种治疗方法治疗ＤＭＥ的优势。方法：将糖尿病性视网膜病变（DR）伴黄斑水肿行玻切联合全视网膜光凝手术治疗的患者62例（62眼）随机分为联合曲安奈德治疗的联合治疗组（33眼术中行玻璃体腔注射ＴＡ联合治疗）和单纯手术治疗的单纯手术组（29眼仅行手术治疗）。比较治疗前及治疗后１个月、３个月和６个月２组患者最佳矫正视力（BCVA）、黄斑光学相干断层扫描（OCT）检测黄斑中心凹处视网膜厚度（CMT）及眼压（IOP）的变化。结果：经过治疗，２组患者BCVA均获得提高，联合治疗组较单纯手术组患者视力提高更多（Plt;0.05）。与治疗前比较，治疗后1个月、3个月和6个月时2组患者CMT均降低（Plt;0.05）。治疗后各阶段联合治疗组CMT均值小于单纯手术组（Plt;0.05）。治疗过程中2组患者均未发生脉络膜脱离和感染性眼内炎等眼部严重并发症。结论：玻切联合全视网膜光凝治疗DR并发黄斑水肿时联合玻璃体腔注射TA可以促进水肿吸收并改善患者视力，且操作简单，并发症少。 　　关键词：玻切手术；曲安奈德；糖尿病视网膜病变；黄斑水肿 　　Abstract Objective：To disuss the efficacy and safety combined with Intravitreal injection of triamcinolone acetonide（TA）in vitrectomy surgery in the treatment of diabetic macular edema（DME），And to clarify the treatment of the advantages of DME.Methods：diabetic retinopathy（DR）with macular edema underwent vitrectomy combined with retinal photocoagulation operation therapy in 62 patients（62 eyes）were randomly divided into treatment for combined with triamcinolone acetonide combined treatment group（33 eyes underwent intravitreal injection of TA combined treatment）of simple operation group therapy and simple operation（29 eyes only for operation treatment）.Before treatment and after treatment for 1 months，3 months and 6 months，2 groups of patients with best corrected visual acuity（BCVA），macular optical coherence tomography（OCT）foveal retinal thickness detection（CMT）and intraocular pressure（IOP）changes.Results：after treatment，2 groups of patients with BCVA were improved，the combined treatment group compared with the simple operation group patients vision improved more（Plt;0.05）.Compared with before treatment，after treatment for 1 months，3 months and 6 months of 2 groups of patients with CMT were decreased（Plt;0.05）.After the treatment of each stage of the combined treatment group CMT means less than simple operation group（Plt;0.05）.In the course of treatment in the 2 groups of patients without