玻璃体切除术治疗玻璃体积血患者临床分析

Clinical Analysis of Vitrectomy for Vitreous Hemorrhage

摘要: 目的：总结并分析玻璃体积血患者临床资料，探讨玻璃体切除术治疗玻璃体积血患者临床效果。方法：收集收治入院进行手术治疗的278例玻璃体积血患者临床资料，总结患者年龄，性别、病程、病因、手术方式等临床特征、分析患者手术前后脱盲率差异及最佳矫正视力差异，探讨玻璃体切除术治疗玻璃体积血的临床效果。结果：纳入玻璃体积血患者共278例，男女比例为1.11:1，45~59岁人群患病比例最高(46.76%)，80岁以上(0.01)和30岁以下(0.02%)人群患病比例最低；病程在2周内患者148例(53.24%)，病程在3月内患者241例(86.69%)；合并高血压102例(36.69%)，合并糖尿病107例(38.49%)；糖尿病视网膜病变所致98例(占比35.25%)，外伤所致84例(占比30.22%)，视网膜静脉阻塞所致36例(占比12.95%)；实施玻璃体切除术中，填充硅油189例(67.99%)，行黄斑前膜剥除94例(33.81%)，行晶体摘除85例(30.58%)；玻璃体切除术后视力明显提高(z = −9.73, P < 0.01)，单眼盲率由术前88.13%降低为术后的43.53%。结论：玻璃体积血为眼科常见病，多发于中老年人群，玻璃体积血患者合并高血压、糖尿病比例高，主要由糖尿病视网膜病变、外伤及视网膜静脉阻塞等病因所致，玻璃体切除术能清除玻璃体积血，探查或复位视网膜，挽救患者视力，是药物治疗效果不佳的患者的首选手术方法。

Abstract: Objective: To summarize and analyze the clinical data of patients with vitreous hemorrhage, and to explore the clinical effect of vitrectomy in the treatment of patients with vitreous hemorrhage. Methods: The clinical data of 278 patients with vitreous hemorrhage for surgical treatment were collected. We summarize clinical characteristics such as age, gender, disease course, etiology, and surgical method, analyze differences in unblinding rate and best corrected visual acuity before and after surgery, and explore the clinical effect of vitrectomy for the treatment of vitreous hemorrhage. Results: A total of 278 patients with vitreous hemorrhage were included, with a male-to- female ra-tio of 1.11:1, the highest proportion of people aged 45~59 years (46.76%), the population aged 80 and above (0.01) and under 30 (0.02%) have the lowest incidence of disease; 148 patients (53.24%) had a disease course within 2 weeks, and 241 patients (86.69%) had a disease course within 3 months; 102 cases with hypertension (36.69%), 107 cases (38.49%) with diabetes, 98 cases were caused by diabetic retinopathy (accounting for 35.25%), 84 cases were caused by trau-ma (accounting for 30.22%), 36 cases were caused by retinal vein occlusion (accounting for 12.95%); 189 cases (67.99%) were filled with silicone oil during vitrectomy, 94 cases (33.81%) underwent premacular membrane removal, and 85 cases (30.58%) underwent lens removal; the visual acuity after vitrectomy was significantly improved (z = −9.73, P < 0.01), and the monocular blindness rate decreased from 88.13% before surgery to 43.53% after surgery. Conclusion: Vitre-ous hemorrhage is a common disease in ophthalmology, which occurs mostly in middle-aged and elderly people. The proportion of patients with vitreous hemorrhage combined with hypertension and diabetes is high. It is mainly caused by diabetic retinopathy, trauma and retinal vein occlusion. Vitrectomy can remove vitreous hemorrhage, and explore or reattach the retina, to save the pa-tient’s vision, regarded as preferred surgical method for patients with poor drug treatment.