目的:观察组织型纤维蛋白溶解酶原激活剂 (t PA)玻璃体腔内注射对玻璃体积血 ,眼底出血的治疗效果。方法 :应用t PA 12 5 μg注射于 36人 38只眼玻璃体腔内 ,治疗不同病期、年龄、形态的玻璃体积血 ,眼底出血。结果 :t PA治疗效果与病程、混浊物形态有关 ,病程在 16～ 90天时显效率为 41 2～ 90 % ,混浊物为块状或膜状时显效率为37 5～ 2 8 6 % ,眼底出血显效率为 6 6 7%。结论 :玻璃体积血已形成凝块 ,应向玻璃体腔内注入 12 5 μgt PA促进纤溶 ,加速积血清除 ,部分病人可免于玻璃体切除手术 ;玻璃体积血合并视网膜脱离者应尽快治疗视网膜脱离 ;对眼底出血 ,黄斑尚无囊样变性 ,视力较差者 ,可试行治疗 Objective: To observe the therapeutic effect of tissue plasminogen activator (t PA) intravitreal injection on vitreous hemorrhage and fundus hemorrhage. Methods: The t PA 12 5 μg was injected into the vitreous cavity of 36 eyes of 38 eyes to treat vitreous hemorrhage of different stages, ages and forms. Results: The therapeutic effect of t PA was related to the course of disease and the morphology of opacity. The effective rate was 41 2 ~ 90% at 16 ~ 90 days and 37 5 ~ 28 6% at turbid mass or film, Bleeding markedly effective rate of 6 6 7%. Conclusion: Vitreous hemorrhage has formed a clot, should be injected into the vitreous cavity of 12 5 μgt PA to promote fibrinolysis, accelerate the hematoma clearance, some patients may be free from vitrectomy surgery; vitreous hemorrhage with retinal detachment should be treated retinal detachment as soon as possible ; On the fundus hemorrhage, macular no cystic degeneration, poor eyesight, trial treatment