地塞米松联合曲安奈德球后注射治疗视网膜静脉阻塞继发黄斑水肿的临床研究

摘要

Objective To investigate the therapeutical effect of injecting dexamethasone( DM ) in early term combined with triamcinolone acetonide ( TA ) in the later period on the macular edema induced by retinal vein ohstruction.Methods 83 cases( 83 eyes ) of retinal vein occlusion and induced macular edema in our Department of Ophthalmology in the part 2 years were divided into DM ＋ TA group( 41 eyes ) and TA group( 42 eyes ). After injecting drug, the best corrected vision , the change of macular edema and complication were checked in the indicated times( 1 、2w , 1、2、3、4 、5、6 mon ).The result was analyzed by the statistical method. Results After treatment with different administer, the best corrected vision of DM ＋ TA group was improved ohviously comparing with that of TA group( t =2.497 ,2.191 ,2.263 ,2.250,3. 347 ,3. 266 ,3. 266 ,2. 763 , P = 0. 026 ,0. 046 ,0. 040 ,0. 041 ,0. 005 ,0.006 ,0.015 ) in other indicated times except for the first week;The degree of macular edema in DM ＋ TA group was relieved ohviously comparing with that in TA group( t = -2. 181 , - 2. 457 , - 2. 198 , - 2. 913 , - 2. 810 , P = 0. 047 ,0. 028 ,0. 045 ,0. 011 ,0. 014 ) and the course of disease was shortened; Complications was no significantly difference between two groups( X2 = 0. 183 , P = 0. 668 ＞ 0. 05 ). Conclusion It was significant that the theraPeutical effect of injecting dexamethasone( DM ) in early term combined with triamcinolone acetonide ( TA ) in later term on the macular edema induced by retinal vein ohstruction, as well as vision improved and the course of disease shortened obviously , and safe was high.%目的 探讨早期球后注射地塞米松(DM)联合后期注射曲安奈德(TA)对视网膜静脉阻塞(RVO)继发黄斑水肿的治疗作用.方法 将我院眼科中心2年间83例(83只眼)确诊为视网膜静脉阻塞并继发黄斑水肿患者随机分为DM+TA组(41只眼)和TA组(42只眼).两组注药后,在指定的时间点(1、2周,1、2、3、4、5、6个月)分别检查最佳矫正视力、黄斑水肿的变化及并发症的情况.采用统计学方法进行分析.结果 两组患者经两种不同给药治疗后,除第1周外,其他各时间点DM+TA组最佳矫正视力较TA组明显提高(分别t=2.497、2.191、2 263、2.250、3.347、3.266、3.266、2.763,P=0.026、0.046、0.040、0.041、0.005、0.006、0.015,均<0.05,有统计学意义);第1、2周,4、5、6个月时DM+TA组黄斑水肿程度明显减轻(分别t=-2.181、-2.457、-2.198、-2.913、-2.810,P=0.047、0.028、0.045、0.011、0.014,均<0.05,有统计学意义),病程明显缩短;两组间并发症发生率均无统计学差异(χ2=0.183,P=0.668>0.05).结论 早期球后注射DM联合后期注射TA对RVO继发黄斑水肿有显著的治疗效果,视力明显提高,病程明显缩短,且安全性高.