糖尿病视网膜病变患者玻璃体切除术后玻璃体出血及复发性出血的危险因素分析。

Analysis of risk factors for vitreous hemorrhage and recurrent hemorrhage after vitrectomy in patients with diabetic retinopathy.

作者信息

Lu Shuwen, Li Haoyu, Ma Chao, Li Xian

机构信息

Department of Ophthalmology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China.

Department of Ophthalmology, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, No. 19 Renmin Road, Zhengzhou, 450000, Henan, China.

出版信息

BMC Ophthalmol. 2025 May 7;25(1):274. doi: 10.1186/s12886-025-04112-w.

DOI:10.1186/s12886-025-04112-w

PMID:40335915

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12057211/

Abstract

PURPOSE

To investigate the risk factors associated with recurrent hemorrhage following vitrectomy surgical intervention for diabetic retinopathy (DR).

METHODS

A retrospective analysis was conducted on 579 eyes diagnosed with DR necessitating surgical intervention. These cases were categorized into two groups: recurrent hemorrhage and non-recurrent hemorrhage. Comparative, random forest (RF), and regression analyses were subsequently performed to evaluate variables pertaining to patients' demographic information, clinical examination and blood test results, treatment approaches, lifestyle habits, and overall health status.

RESULTS

This study compared patients with recurrent and non-recurrent hemorrhages, revealing significant differences in factors such as endodiathermy, anticoagulant use, cerebrovascular diseases, smoking status, glycosylated hemoglobin levels and BMI. Patients with no recurrent hemorrhage have faster vision recovery. The univariable logistic regression analysis indicated that cerebrovascular disease (OR = 7.87, P < 0.001), anticoagulant use (OR = 16.72, P < 0.001), and elevated glycated hemoglobin levels (OR = 21.22, P < 0.001) exhibited strong associations with recurrent hemorrhage. The multivariable logistic regression analysis indicated that recurrent hemorrhage risk factors include anticoagulant use (OR = 120.77, P = 0.020) and glycated hemoglobin levels (OR = 18.41, P = 0.001).

CONCLUSIONS

Recurrent postoperative hemorrhage is influenced by several factors, notably the use of intraoperative endodiathermy, adjustments in ocular therapy, and management of the patient's systemic condition. In clinical practice, careful consideration of these factors is essential to mitigate postoperative hemorrhage in patients.

摘要

目的

探讨糖尿病视网膜病变（DR）玻璃体切除手术干预后复发性出血的相关危险因素。

方法

对579例诊断为需要手术干预的DR患者的眼睛进行回顾性分析。这些病例分为两组：复发性出血组和非复发性出血组。随后进行比较分析、随机森林（RF）分析和回归分析，以评估与患者人口统计学信息、临床检查和血液检查结果、治疗方法、生活习惯及整体健康状况相关的变量。

结果

本研究比较了复发性出血和非复发性出血患者，发现内凝术、抗凝剂使用、脑血管疾病、吸烟状况、糖化血红蛋白水平和体重指数等因素存在显著差异。无复发性出血的患者视力恢复更快。单变量逻辑回归分析表明，脑血管疾病（OR = 7.87，P < 0.001）、抗凝剂使用（OR = 16.72，P < 0.001）和糖化血红蛋白水平升高（OR = 21.22，P < 0.001）与复发性出血密切相关。多变量逻辑回归分析表明，复发性出血的危险因素包括抗凝剂使用（OR = 120.77，P = 0.020）和糖化血红蛋白水平（OR = 18.41，P = 0.001）。