方法：回顾性分析增殖性糖尿病视网膜病变行23G玻璃体切除、联合白内障超声乳化、人工晶状体植入、硅油充填术的271例271眼，行硅油取出术后继发新生血管性青光眼的14例14眼，对照组(none neovascular glaucoma，NNVG)为随机抽取同期手术后未继发NVG的同年龄、同手术方式、排除对侧眼做对比，分析发生NVG的时间、围手术期血压、血糖变异性，随访时间为手术后1～12mo，用SPSS 11.0统计学软件分析本组新生血管性青光眼的发病率、发病时间、围手术期血糖、血压、糖化血红蛋白(Hbc%)的变异性。

结果：患者271例14眼继发NVG，占5.2%； 男10眼(71.4%)，女4眼(28.6%)； 年龄49～68(平均57.07)岁； 继发NVG的时间为玻璃体切除术后107～135d，硅油取出术后7～45(平均31.78)d； 糖尿病史10～15(平均13.2)a。NVG组：围手术期空腹血糖波动4.0～10.2(平均8.52±3.24)mmol/L，变异系数0.48。NNVG组：围手术期空腹血糖波动5.0～8.2(平均7.22±0.24)mmol/L，变异系数0.43，两组变异系数差异有显著差异(P<0.05)。Hbc% NVG组：(10.52±0.27)%，NNVG组：(7.60±1.34)%，两组比较差异有统计学意义(P<0.05)。NVG组：围手术期收缩压140～180(平均152.3±15.1)mmHg，变异系数0.099，舒张压50～110(平均92.3±11.1)mmHg，变异系数0.11； NNVG组：围手术期收缩压120～150(平均131.4±0.1)mmHg，变异系数0.061，舒张压80～100(平均87.3±8.1)mmHg，变异系数0.08； 两组相比，变异系数有差异(P<0.05)，NVG组围手术期空腹血糖的变异性明显大于NNVG组。而两组之间昼夜血压的变异性相比，NVG组白天的收缩压(systolic blood pressure，SBP)以及夜晚的舒张压(diastolic blood pressure，DBP)的变异性均大于NNVG组，均有统计学意义(P<0.05)。14例患者取油术与玻璃体切除硅油注入手术围手术期血糖的变异性、血压的变异性相比无统计学意义。

结论：PDR继发NVG患者围手术期空腹血糖的变异性、白天收缩压、夜间舒张压的变异性大，最早可发生在硅油取出术后1wk。

METHODS: Totally, 271 patients(271 eyes)undergone surgery of vitrectomy and silicon-oil tamponade combined with cataract were respective analyzed. Fourteen patients(14 eyes)with secondary NVG after silicon oil removed and randomly controlled group of no NVG according with ages, operation method in the same time were studied. The blood pressure and blood glucose variability during peroperative period was analyzed, and did comparison after excluded contralateral eye. The complications of 271 patients were surveyed in following-up period 1～12mo. The incidence of NVG, the time, blood pressure, blood glucose and glycated hemoglobin(Hbc%)variability during peroperative period was statisticed and compared by software of SPSS 11.0.

RESULTS: Fourteen eyes(5.2%)of 271 cases was with secondary NVG(female: 4 eyes, 28.6%; male: 10 eyes, 71.4%), average ages was 57.07 years(49～68 years). NVG presented in the 107～ 135d after vitrectomy and 7～45d(average 31.78d)after silicon-oil removed. Diabetes mellitus was 10～15(average 13.2)a. In NVG group, the variability of blood glucose was 4.0～10.2mmol/L(mean 8.52±3.24mmol/L), variable coefficient was 0.48. In NNVG group, the variability of blood glucose was 5.0～8.2mmol/L(mean 7.22±0.24mmol/L), variable coefficient was 0.43. It was significantly difference in comparison in variable coefficient(P<0.05). Hbc% was 10.52%±0.27% in NVG group and 7.60%±1.34% in NNVG group, there was a statistical difference(P<0.05). The average systolic blood pressure(SBP)was 152.3±15.1mmHg(140～180mmHg)with variable coefficient was 0.099 in NVG group and 131.4±0.1mmHg(120～150mmHg)with variable coefficient 0.061 in NVG group. While the average diastolic blood pressure(DBP)was 92.3±11.1mmHg(50～110mmHg)with variable coefficient 0.11 in NVG group and 87.3±8.1mmHG(80～100mmHg)with variable coefficient 0.08 in NNVG group. Compared the two groups, there were differences in variable coefficient(P<0.05). Blood glucose variability of perioperative in NVG group was significantly greater than that in NNVG group. Compared between the two groups, variability of daytime SBP and night DBP in NVG group were more than those in NNVG group with statistically significant differences(P<0.05). Perioperative blood glucose and blood pressure variability showed no statistical significance in 14 patients after taking oil surgery and vitrectomy with silicone oil tamponade.

CONCLUSION: There are significant variability on fasting blood glucose, daytime SBP and night DBP during perioperative in PDR patients with secondary NVG. It might be occurred 1wk after silicone oil removal surgery.