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1、·6·中华现代中西医杂志ChineseJournalofCurrentTraditionalandWesternMedicine2007年第5卷第1期·论著·复合式玻璃体视网膜手术治疗增殖型糖尿病视网膜病变的疗效分析12马贤智,董方田[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(proliferativediabeticretinopathy,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
2、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8816%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%CF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38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[中图分类号]R774.1[文献标识码]A[
3、文章编号]1726-6424(2007)01-0006-04Theanalysisoftheeffectofvitreoretinalsurgeryonthetreatmentofprolifera2tivediaketicretinopathyMAXian2zhi,DONGFang2tian.DepartmentofOphthamology,ChangjiHospitalofTCM,Changji831100,China[Abstract]ObjectiveToanalyseretrospectivelytheclinicaleffectofvitreoretinalsurgeryo
4、nthetreatmentofproliferativediabeticretinopathy.MethodsTwohundredandseventy2twopatients(338eyes)inhospital,inclu2ding126males(156eyes)and146females(182eyes),whoseagerangfrom34to76yearsold,mean55yearsold,wereoperatedvitreoretinalsurgeryaftercontrollingbloodsugarandbloodpressure.Toanalysethepatien
5、ts곰ma2terialspre2andpost2operationduringhospitalandpre2andpost2operativeeyesightofpatientsindifferentteamsandfindouttheinfluentfactorsontheoperativeeffect.Results8816%ofpatientswereprogressivetodifferentextentafteroperation.Therearesomefactorsthataffectthepostoperativeeyesightinthenearfuture,inc
6、ludingthedegreeofproliferativediabeticretinopathy,secondaryvitreoushemorrhage,thefillingof16%C3F8orsiliconoil.Thepa2tientswithvitreousre2hemorrhageinthenearfutureweretimelyoperatedtheextractionofvitreousbody,treatedthehemorrhage.ConclusionThevitreoretinalsurgeryistheonlyeffectivemethodofprotecti
7、ngeyefunctionandpro2motingeyesightonproliferativediabeticretinopathy.Bytheearlydiagnosisandstage,correctchoiceofoperativea2daptivediseasesandoperativestage,promotingoperativetechnologyandpreventingcomplications,thepostoperat
