中国现代医学杂志2023，Vol.33Issue(24)：55-59,5.DOI:10.3969/j.issn.1005-8982.2023.24.010
增殖性糖尿病视网膜病变患者玻璃体切除术后玻璃体再积血的影响因素及预后分析
Factors affecting postoperative vitreous hemorrhage after vitrectomy and prognostic analysis in patients with proliferative diabetic retinopathy
摘要
Abstract
Objective To study the factors affecting postoperative vitreous hemorrhage(PVH)after pars plana vitrectomy(PPV)and prognostic analysis in patients with proliferative diabetic retinopathy(PDR).Methods The clinical data of 156 patients with PDR in the Affiliated Hospital of Nantong University from February 2019 to February 2022 were collected retrospectively.All patients underwent PPV,and were divided into PVH group and non-PVH group according to whether PVH occurred 6 months after surgery.The clinical characteristics of the two groups were compared,and factors affecting the occurrence of PVH were analyzed by the multivariable Logistic regression model.Besides,the prognosis of the patients was compared between the two groups.Results The incidence of PVH within 6 months after PPV was 13.46％(21/156)among patients with PDR.There was no significant difference between the two groups in sex composition,age,course of diabetes mellitus,history of laser eye surgery,presence of iris neovascularization(NVI),systolic blood pressure(SBP),diastolic blood pressure(DBP),visual acuity,grayscale representation of visual field,macular thickness,duration of PPV,intraoperative laser photocoagulation treatment and intraoperative use of filling materials(P＞0.05).The percentage of stage VI PDR,proportion of proliferative retinal traction,level of glycosylated hemoglobin(HbAlc),and postoperative intraocular pressure in the PVH group were significantly higher than those in the non-PVH group(P＜0.05).The multivariable Logistic regression analysis showed that the PDR stage[(OR)=4.591(95％CI:1.997,10.550)],presence of proliferative retinal traction[(OR)=3.736(95％CI:1.626,8.586)],the level of HbAlc[(OR)=4.293(95％CI:1.868,9.867)]and postoperative intraocular pressure[(OR)=3.666(95％CI:1.595,8.425)]were all factors affecting the occurrence of PVH after PPV in PDR patients(P＜0.05).The prognosis of the non-PVH group was better than that of the PVH group(P＜0.05).Conclusions Factors affecting the occurrence of PVH after PPV in PDR patients include the PDR stage,combination of proliferative retinal traction,the level of HbAlc,and postoperative intraocular pressure,while PVH may affect the prognosis of visual acuity.关键词
增殖性糖尿病视网膜病变/玻璃体切除术/玻璃体再积血/影响因素/预后Key words
proliferative diabetic retinopathy/vitrectomy/vitreous hemorrhage/influencing factors/prognosis分类
医药卫生引用本文复制引用
周天球,朱曦,施祥..增殖性糖尿病视网膜病变患者玻璃体切除术后玻璃体再积血的影响因素及预后分析[J].中国现代医学杂志,2023,33(24):55-59,5.基金项目
江苏省自然科学基金青年基金(No:BK20200965) （No:BK20200965）
