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目的:探讨玻璃体腔注药联合微创玻璃体切除治疗糖尿病视网膜病变的临床疗效。方法:选择2014年1月至2016年1月在我院确诊并治疗的增生性糖尿病视网膜病变患者80例,共83只患眼,随机分为A、B两组。A组共42例患眼,接受25 G玻璃体微创手术;B组共41例患眼,在A组治疗的基础上给予玻璃体腔注射康柏西普。比较两组患者的手术情况、治疗前后最佳视力的矫正(Best-corrected visual acuity,BCVA)情况、视网膜厚度以及术后1个月不良反应的发生情况。结果:B组患者的手术时间较A组显著缩短(P<0.05),且术中使用电凝的患眼、术中出血以及术中发生医源性裂隙的患眼比例显著低于A组(P<0.05),新生血管消失的患眼比例显著高于A组(P<0.05)。B组患者术后1个月和3个月的BVCA显著高于A组(P<0.05),且术后视网膜的厚度显著薄于A组(P<0.05),术后发生玻璃体积血和前方出血的患眼比例显著低于A组(P<0.05)。结论:玻璃体腔注射康柏西普联合25G玻璃体微创切除术治疗增生性糖尿病视网膜病变的临床疗效显著,有利于患者术后视力以及视网膜恢复。
Objective: To investigate the clinical efficacy of intravitreal injection combined with minimally invasive vitrectomy in the treatment of diabetic retinopathy. Methods: 80 patients with proliferative diabetic retinopathy diagnosed and treated in our hospital from January 2014 to January 2016 were selected. A total of 83 eyes were randomly divided into A and B groups. Forty-two patients in group A received 25-G vitreous minimally invasive surgery; in group B, 41 patients received intraocular injection of compstatin on the basis of group A treatment. The operation conditions, the best-corrected visual acuity (BCVA) before and after treatment, the retinal thickness and the incidence of adverse reactions one month after the operation were compared between the two groups. Results: The operation time of group B was significantly shorter than that of group A (P <0.05), and the proportion of eyes with intraoperative coagulation, intraoperative bleeding and iatrogenic fissures were significantly lower than those in group A P <0.05). The proportion of neovascular disappeared was significantly higher than that in group A (P <0.05). The BVCA at 1 month and 3 months after operation in group B was significantly higher than that in group A (P <0.05), and the thickness of postoperative retina was significantly thinner than that in group A (P <0.05). The postoperative vitreous hemorrhage and frontal The proportion of bleeding eyes was significantly lower than in group A (P <0.05). Conclusion: Intravitreal injection of Compaqeep combined with 25G vitrectomy for the treatment of proliferative diabetic retinopathy has significant clinical effect, which is good for postoperative visual acuity and retinal recovery.