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目的 评价氟尿嘧啶联合低分子肝素在预防玻璃体切割术后增殖性玻璃体视网膜病变发生过程中的安全性和有效性。方法 本研究随机选择本科2 0 0 3 4～2 0 0 3 11间需行玻璃体手术治疗的视网膜脱离患者5 0例5 0眼,病例选用标准为具有玻璃体术后视网膜脱离复发的高危因素的患者,分成治疗组与对照组,治疗组灌注液中加入低分子肝素和氟尿嘧啶,药物灌注时间控制在35～4 5分钟之间。随访3个月,对两组结果进行对比分析。结果 随访3个月后,治疗组与对照组术后增殖性玻璃体视网膜病变的发生率分别为8% (2 / 2 5 )和36 % (9/ 2 5 ) ,有显著性差异(P =0.0 4 1)。治疗组术后因PVR造成的视网膜脱离复发率为4 % (1/ 2 5 ) ,对照组为16 % (4/ 2 5 ) ,治疗组1例和对照组4例患者成功的进行了视网膜的再次复位手术。没有发现有明显的与药物有关的眼部并发症。结论 虽然术后3个月时两组视网膜脱离的复发率差异没有统计学意义,但治疗组术后增殖性玻璃体视网膜病变的发生率较对照组有意义的减少。本试验显示了手术联合氟尿嘧啶与低分子肝素可以预防术后PVR的发生
Objective To evaluate the safety and efficacy of fluorouracil combined with low molecular weight heparin in the prevention of proliferative vitreoretinopathy after vitrectomy. Methods Fifty patients (50 eyes) with retinal detachment undergoing vitreous surgery were selected randomly from 2 0 0 3 4 to 2 0 0 3 1 1 in our study. The patients were selected as the patients with high risk of retinal detachment after vitrectomy , Divided into treatment group and control group, the treatment group perfusion solution by adding low molecular weight heparin and fluorouracil, drug infusion time control between 35 ~ 45 minutes. Followed up for 3 months, the results of two groups were compared. Results After 3 months of follow-up, the incidence of proliferative vitreoretinopathy was 8% (2/25) and 36% (9/2 5) respectively in the treatment group and the control group, with significant difference (P = 0.0 4 1). The recurrence rate of retinal detachment due to PVR was 4% (1/25) in the treatment group and 16% (4/25) in the control group, and 1 patient in the treatment group and 4 patients in the control group were successfully treated with retinal detachment Reset the surgery again. No obvious drug-related ocular complications were found. Conclusion Although there was no significant difference in the recurrence rate of retinal detachment between the two groups at 3 months after operation, the incidence of proliferative vitreoretinopathy in the treatment group was significantly decreased compared with the control group. This study shows that surgery combined with fluorouracil and low molecular weight heparin can prevent the occurrence of postoperative PVR