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目的评价23G微创玻璃体切割手术治疗糖尿病视网膜病变(DR)的临床效果。方法 110例DR患者,根据手术方式不同分为23G组(61眼,采用23G微创玻璃体切除手术进行治疗)和20G组(59眼,采用20G微创玻璃体切除手术进行治疗),各55例。对两组患者的手术时间以及术中并发症进行比较,并比较两组术后1、3、6个月的视力及眼压。结果 23G组手术时间为(88.53±12.71)min,短于20G组的(121.36±28.94)min,差异有统计学意义(P<0.05)。与术前比较,两组术后视力均得到明显的改善,差异有统计学意义(P<0.05);两组术后1、3、6个月的视力以及眼压比较差异无统计学意义(P>0.05)。23G组术中发生医源性裂孔2例、需电凝止血4例,并发症发生率为10.91%(6/55);20G组分别发生5、9例,并发症发生率为25.45%(14/55);23G组并发症发生率明显低于20G组(P<0.05)。结论 23G微创玻璃体切割手术治疗DR患者可以取得比较理想的临床效果,且并发症较少,可以进行临床推广。
Objective To evaluate the clinical effect of 23G minimally invasive vitrectomy in the treatment of diabetic retinopathy. Methods A total of 110 patients with DR were divided into 23G (61 eyes) treated with 23G minimally invasive vitrectomy and 59 eyes (55 eyes treated with 20G minimally invasive vitrectomy) according to different surgical methods. The operation time and intraoperative complications of two groups were compared, and the visual acuity and intraocular pressure of the two groups were compared at 1, 3 and 6 months after operation. Results The operation time of 23G group was (88.53 ± 12.71) min, shorter than that of 20G group (121.36 ± 28.94) min, the difference was statistically significant (P <0.05). Compared with the preoperative, visual acuity was significantly improved in both groups, the difference was statistically significant (P <0.05); visual acuity and intraocular pressure in the two groups at 1, 3 and 6 months postoperatively had no significant difference P> 0.05). There were 2 cases of iatrogenic hiatus in operation 23 in group 23 and 4 cases in need of electrocoagulation. The incidence rate of complications was 10.91% (6/55). There were 5 and 9 cases in group 20G respectively, with a complication rate of 25.45% (14 / 55). The incidence of complications in 23G group was significantly lower than that in 20G group (P <0.05). Conclusion 23G minimally invasive vitrectomy for patients with DR can achieve better clinical results, and fewer complications, the clinical promotion.