[关键词]
[摘要]
全视网膜激光光凝术(PRP)是治疗重度非增殖性糖尿病视网膜病变和增殖性糖尿病视网膜病变(PDR)的一线方案。受患者全身情况及眼部条件等多种因素影响，其疗效差异较大。部分患者虽经规范激光治疗，仍难以遏制新生血管进展，出现玻璃体积血(VH)。对于此类患者，玻璃体切割术(PPV)能够有效清除积血、恢复屈光间质透明，补充PRP，延缓PDR进展，已成为重要干预手段。近年来，随着手术技术、理念及设备的不断革新，早期PPV治疗PDR患者PRP后VH方面日益成为研究热点，但其手术适应证、手术时机及手术方案尚未形成共识。文章系统梳理了近年国内外的相关研究，围绕PPV治疗PDR患者PRP后VH的手术时机、手术方案及预后等进行总结，以期为临床决策提供循证参考，降低PDR致盲风险。
[Key word]
[Abstract]
Panretinal photocoagulation(PRP)is the first-line treatment for severe non-proliferative diabetic retinopathy and proliferative diabetic retinopathy(PDR).Its therapeutic efficacy varies due to multiple patient-specific systemic and ocular factors. Despite standardized PRP, some patients fail to show adequate regression of neovascularization and subsequently develop vitreous hemorrhage(VH). In such cases, pars plana vitrectomy(PPV)effectively clears the hemorrhage, restores transparency of the ocular media, supplement PRP, and delays the progression of PDR, thus becoming a critical intervention. With recent advances in surgical techniques, concepts, and equipment, early PPV intervention for VH following PRP has emerged as a growing research focus. Nevertheless, consensus remains lacking regarding its indications, optimal timing, and surgical protocols. This article systematically reviews relevant domestic and international studies, summarizing the surgical timing, approaches, and prognoses of PPV for VH in PDR patients after PRP, aiming to provide evidence-based reference for clinical decision-making and reduce the risk of PDR-related blindness.
[中图分类号]
[基金项目]
山东省医药卫生科技发展计划项目(No.2019WS333); 2020年滨州医学院附属医院科研计划项目(No.BY2020KJ56); 滨州医学院教学改革与研究立项项目(No.JYKTLX202284)
