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糖尿病性玻璃体积血早期 25G 玻璃体切除术后再发性玻璃体积血的危险因素调查。

Investigation of the recurrent vitreous hemorrhage risk factors after early 25G vitrectomy in diabetic vitreous hemorrhage.

机构信息

Pamukkale University, Ophthalmology Department, Denizli, Turkey.

出版信息

Medicine (Baltimore). 2024 Jan 19;103(3):e36963. doi: 10.1097/MD.0000000000036963.

Abstract

Vitreous hemorrhage (VH) is one of the main causes of vision loss in diabetic retinopathy (DRP). Early surgery increases the visibility of the retina, allowing early recognition of DRP complications and additional treatments. One of the most important reasons affecting success after surgery is recurrent vitreous hemorrhage (RVH). We aimed to investigate the risk factors for RVH after early 25G vitrectomy in diabetic VH. Eighty eyes of eighty patients who underwent early 25G PPV surgery with a diagnosis of VH due to proliferative diabetic retinopathy (PDR) were included in this retrospective study. Vision acuity changes and intraocular pressure (IOP) changes were compared. The effect of arterial hypertension (HT), coronary artery disease (CAD), preoperative antiglaucomatous usage, and anticoagulant usage on RVH was investigated. A value of P < .05 was accepted as statistically significant. Postoperative RVH was observed in 18 (22.5%) patients. There was no correlation between the age of the patients and the development of postoperative RVH (r = -0.197, P = .08). The rate of HT and the mean HbA1C levels were found to be higher in the patients who developed RVH than in those who did not (P = .04 and < 0.001, respectively). The presence of CAD, preoperative glaucoma disease, and the use of anticoagulants did not have any effect on RVH (P = .229, 0.843, 0.932, respectively). HT and increased HbA1c were found to be risk factors for RVH in VH patients who underwent 25G vitrectomy in the early period in our study.

摘要

玻璃体积血 (VH) 是糖尿病性视网膜病变 (DRP) 导致视力丧失的主要原因之一。早期手术可提高视网膜的可视性,有助于及早发现 DRP 并发症并进行额外治疗。影响手术后成功的最重要原因之一是复发性玻璃体积血 (RVH)。我们旨在研究影响早期 25G 玻璃体切除术治疗糖尿病性 VH 后 RVH 的风险因素。本回顾性研究纳入了 80 例因增生性糖尿病性视网膜病变 (PDR) 而接受早期 25G 经睫状体平坦部玻璃体切除术 (PPV) 手术治疗的 VH 患者的 80 只眼。比较了视力变化和眼压 (IOP) 变化。研究了动脉高血压 (HT)、冠心病 (CAD)、术前抗青光眼药物使用和抗凝药物使用对 RVH 的影响。P 值<.05 被认为具有统计学意义。18 例 (22.5%) 患者术后出现 RVH。患者年龄与术后 RVH 发展之间无相关性 (r = -0.197,P =.08)。与未发生 RVH 的患者相比,发生 RVH 的患者 HT 发生率和平均 HbA1C 水平更高 (P =.04 和 <.001)。CAD、术前青光眼疾病和抗凝药物的使用对 RVH 无任何影响 (P =.229、0.843 和 0.932)。HT 和 HbA1c 升高被认为是本研究中接受早期 25G 玻璃体切除术治疗 VH 患者发生 RVH 的危险因素。

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