增殖性糖尿病视网膜病变术前应用贝伐单抗的临床观察

Clinical observation on preoperative application of Bevacizumab in proliferative diabetic retinopathy

摘要:

目的：探讨增殖性糖尿病视网膜病变(proliferative diabetic retinopathy，PDR)患者玻璃体切割(PPV)术前行玻璃体腔内注射贝伐单抗(Bevacizumab)对玻璃体手术的疗效及安全性的影响。

方法：对74例80眼PDR患者进行回顾性研究，74例80眼患者随机分为玻璃体切割术组(对照组)和玻璃体切割术联合贝伐单抗注射组(观察组)，观察组行玻璃体切割术前10d注射贝伐单抗。观察比较两组手术时间、术后视力、眼压、并发症及术中和术后出血情况。

结果：手术时间：观察组平均手术时间108±20.6min，对照组平均手术时间129±32.4min。 术后视力：观察组术后平均视力0.32±0.20，对照组为0.21±0.16，两组相比存在显著性差异( P<0.05)。观察组术后3mo眼压平均为21.3±7.2mmHg，对照组为20.6±6.7mmHg，两组相比，无显著性差异( P>0.05)。

结论：Bevacizumab能使活跃的新生血管膜纤维化，剥膜过程中出血减少，手术视野清晰，手术时间缩短，术后获得更好的视力，未出现严重并发症。

Abstract:

AIM: To discuss the effects and security of the application of intravitreous bevacizumab(IVB)before pars plana vitrectomy(PPV)in proliferative diabetic retinopathy(PDR).

METHODS: Retrospective study of 74 patients(80 eyes)with PDR. These patients were randomly divided into two groups, some patients in PPV group and others patients in PPV+IVB group. The PPV+IVB group were treated with IVB 10d before operation. The operating time, postoperative eyesight, intraocular pressure(IOP), complications and bleeding during operation and postoperation between the two groups were observed and compared.

RESULTS: Operating time and postoperative visual acuity were significantly different between the two groups. Operating time: with an average of 108±20.6min of test group and 129±32.4min of comparison group. Postoperative visual acuity: with an average of 0.32±0.20 and 0.21±0.16, there was significantly different between the two groups(P<0.05). Three months after operation, IOP was no significantly different between the two groups with an average of 21.3±7.2mmHg and 20.6±6.7mmHg(P>0.05).

CONCLUSION:Bevacizumab can make active neovascular membranes fibrosis, reduce bleeding in the strip membranes process, so as to make the operation field clear, and can shorten the surgical time and get the better sight, no serious complications during postoperative period appeared.