【摘要】 目的 观察玻璃体腔内注射雷珠单抗对增殖性糖尿病视网膜病变(PDR)患者玻切术实施及预后的影响。 方法 选择PDR患者40例(45眼)随机分为试验组20例(22眼)行玻璃体腔内注射Lucentis 0.5 mg，后行玻切术;对照组20例(23眼)直接行玻切术。分析两组术中、术后差异。 结果 试验组平均手术持续时间、术中电凝止血频率及医源裂孔发生率均低于对照组[时间：(96±12) vs (133±15) min，P<0.001;止血百分率：3(13.6%) vs 9(39.1%)，P=0.038;裂空发生率：1(4.54%) vs 4(17.4%)，P=0.034]。试验组术后1个月内前房和玻璃体腔积血率均较对照组降低[前房：1(4.54%) vs 2(8.70%)，P=0.025;玻璃体腔：1(4.54%) vs 3(13.0%)，P=0.048]。两组术后视力均较术前提高，组间比较差异有统计学意义(P=0.020)。 结论 PDR患者在玻切术前注射雷珠单抗可缩短手术时间，减少术中出血及医源性裂孔的发生，减少术中术后并发症，获得更好的术后视力。

　　【关键词】 雷珠单抗;糖尿病视网膜病变;玻璃体切割;影响

　　【Abstract】 Objective To investigating effects of lucentis intravitreal injection before vitrectomy in patients with proliferative diabetic retinopathy(PDR) . Methods 40 patients with PDR were randomized into experiment group [with PDR underwent lucentis (0.5 mg) intravitreal injection before vitrectomy, n=20(22 eyes)] and control group [with PDR underwent vitrectomy directly, n=20(23 eyes)]. The differences of pro- and post-operational were analyzed between two groups. Results The average operative duration, the using frequency of electrocautery and the incidence rate of iatrogenic hole was significantly lower in experiment group than in control group[times：(96±12) vs (133±15) min，P<0.001;using frequency of electrocautery：3(13.6%) vs 9(39.1%)，P=0.038;incidence rate of iatrogenic hole：1(4.54%) vs 4(17.4%)，P=0.034]. For the prognosis, the incidence of postoperative hemorrhage of anterior chamber and vitreous hemorrhage in experiment group was lower than in control group after one month[anterior chamber：1(4.54%) vs 2(8.70%)，P=0.025;vitreous hemorrhage：1(4.54%) vs 3(13.0%)，P=0.048]. The post-operative visual acuity were significantly higher than before in both group, and there was significant difference between two groups. Conclusions Intravital injection lucentis to patients with PDR before vitrectomy can shorten surgery time significantly, reduce the incidence of operative hemorrhage and iatrogenic hole, reduce complications, and get a better visual acuity.

　　【Key words】 Lucentis;Diabetic Retinopathy;Vitrectomy;Effects