【摘要】 目的探讨增生性糖尿病视网膜病变(PDR)患者行玻璃体切除联合非硅油填塞术术后发生牵拉性视网膜脱离(TRD)的非手术危险因素。方法对2015年1月—2018年12月在我院接受玻璃体切除联合非硅油填塞术的48例PDR患者的临床资料进行回顾性分析,按照术后是否发生TRD将患者分为发生组16例(研究组)和未发生组32例(对照组),比较两组患者各项临床观察指标的差异。结果两组患者的PRP治疗史以及血清总蛋白、白蛋白、尿素氮、肌酐水平比较差异有统计学意义(χ~2=5.510,t=-3.549～3.474,P<0.05)。Logistic回归分析显示,患者血清白蛋白浓度是TRD发生的重要危险因素(OR=1.586,95%CI=1.042～2.416,P<0.05);而术前接受PRP是防止TRD发生的保护因素(OR=0.047,95%CI=0.003～0.727,P<0.05)。结论低血清白蛋白和术前未行PRP是PDR患者玻璃体切除联合非硅油填塞术后发生TRD的非手术危险因素,应加强患者的围手术期管理,降低TRD的发生率,提高预后。更多还原

【Abstract】 Objective To investigate the nonsurgical risk factors for tractional retinal detachment(TRD) after vitrectomy combined with non-silicone oil tamponade in patients with proliferative diabetic retinopathy(PDR). Methods A retrospective analysis was performed for the clinical data of 48 patients with PDR who underwent vitrectomy combined with non-silicone oil tamponade in our hospital from January 2015 to December 2018, and according to the presence or absence of TRD after surgery, the patients were divided into TRD group(study group with 16 patients) and non-TRD group(control group with 32 patients). Related clinical indices were compared between the two groups. Results There were significant differences between the two groups in the history of platelet-rich plasma(PRP) treatment and the serum levels of total protein, albumin, urea nitrogen, and creatinine(χ~2=5.510,t=-3.549-3.474,P<0.05). The logistic regression analysis showed that serum albumin concentration was an important risk factor for TRD(OR=1.586,95%CI=1.042-2.416,P<0.05), while preoperative PRP treatment was a protective factor against TRD(OR=0.047,95%CI=0.003-0.727,P<0.05). Conclusion Low serum albumin and absence of preoperative PRP treatment are nonsurgical risk factors for TRD after vitrectomy combined with non-silicon oil tamponade, and perioperative management should be strengthened to reduce the incidence rate of TRD and improve prognosis.更多还原