中外健康文摘
中外健康文摘
중외건강문적
WORLD HEALTH DIGEST
2013年
11期
90-92
,共3页
糖尿病视网膜病变%激光凝固术%治疗效果
糖尿病視網膜病變%激光凝固術%治療效果
당뇨병시망막병변%격광응고술%치료효과
Diabetic retinopathy%Laser coagulation%Treatment outcome
目的观察532nm激光光凝治疗不同分期糖尿病视网膜病变(DR)患者的疗效。方法 对确诊的DR患者86例164只眼，其中，增生前期(PPDR)组64只眼、早期增生期(早期PDR)组58只眼、高危增生期(高危PDR)组42只眼，根据DRPSG(Diabetlc Retinopathy Photocoagulation study Group)制订的治疗技术规定光凝范围和光凝参数行标准全视网膜光凝(S—PRP)和超全视网膜光凝(E—PRP)及黄斑水肿行局限光凝或格栅光凝。每隔3个月采用与治疗前相同的检查设备和方法复查视力、眼底、FFA。新生血管未消退和无灌注区残留补充激光光凝。随访观察9～18个月，平均随访时间10.6个月。以最后一次随访时的观察指标进行疗效评价。结果 PPDR视力有效占81.0%，治疗有效占89.1%；PDR视力有效占78.0，治疗有效占79.3%；高危PDR视力有效占57.0%，治疗有效占47.6%。不同分期DR视力治疗有效率差异有统计学意义(X2=8.200 P<0.05),其中PPDR与PDR视力治疗有效率差异无统计学意义(X2=0.251 P>0.05)；PPDR、PDR分别与高危PDR视力治疗有效率差异有统计学意义(X2=7.2634.759 P<0.05)；局限性水肿组治疗有效率89.3%，弥漫性水肿组治疗有效率68.2%，局限性黄斑水肿组有效率要明显高于弥漫性黄斑水肿组。结论 532nm激光治疗DR安全有效，早期、及时、有效的激光光凝治疗是稳定病变，降低致盲率的关键。
目的觀察532nm激光光凝治療不同分期糖尿病視網膜病變(DR)患者的療效。方法 對確診的DR患者86例164隻眼，其中，增生前期(PPDR)組64隻眼、早期增生期(早期PDR)組58隻眼、高危增生期(高危PDR)組42隻眼，根據DRPSG(Diabetlc Retinopathy Photocoagulation study Group)製訂的治療技術規定光凝範圍和光凝參數行標準全視網膜光凝(S—PRP)和超全視網膜光凝(E—PRP)及黃斑水腫行跼限光凝或格柵光凝。每隔3箇月採用與治療前相同的檢查設備和方法複查視力、眼底、FFA。新生血管未消退和無灌註區殘留補充激光光凝。隨訪觀察9～18箇月，平均隨訪時間10.6箇月。以最後一次隨訪時的觀察指標進行療效評價。結果 PPDR視力有效佔81.0%，治療有效佔89.1%；PDR視力有效佔78.0，治療有效佔79.3%；高危PDR視力有效佔57.0%，治療有效佔47.6%。不同分期DR視力治療有效率差異有統計學意義(X2=8.200 P<0.05),其中PPDR與PDR視力治療有效率差異無統計學意義(X2=0.251 P>0.05)；PPDR、PDR分彆與高危PDR視力治療有效率差異有統計學意義(X2=7.2634.759 P<0.05)；跼限性水腫組治療有效率89.3%，瀰漫性水腫組治療有效率68.2%，跼限性黃斑水腫組有效率要明顯高于瀰漫性黃斑水腫組。結論 532nm激光治療DR安全有效，早期、及時、有效的激光光凝治療是穩定病變，降低緻盲率的關鍵。
목적관찰532nm격광광응치료불동분기당뇨병시망막병변(DR)환자적료효。방법 대학진적DR환자86례164지안，기중，증생전기(PPDR)조64지안、조기증생기(조기PDR)조58지안、고위증생기(고위PDR)조42지안，근거DRPSG(Diabetlc Retinopathy Photocoagulation study Group)제정적치료기술규정광응범위화광응삼수행표준전시망막광응(S—PRP)화초전시망막광응(E—PRP)급황반수종행국한광응혹격책광응。매격3개월채용여치료전상동적검사설비화방법복사시력、안저、FFA。신생혈관미소퇴화무관주구잔류보충격광광응。수방관찰9～18개월，평균수방시간10.6개월。이최후일차수방시적관찰지표진행료효평개。결과 PPDR시력유효점81.0%，치료유효점89.1%；PDR시력유효점78.0，치료유효점79.3%；고위PDR시력유효점57.0%，치료유효점47.6%。불동분기DR시력치료유효솔차이유통계학의의(X2=8.200 P<0.05),기중PPDR여PDR시력치료유효솔차이무통계학의의(X2=0.251 P>0.05)；PPDR、PDR분별여고위PDR시력치료유효솔차이유통계학의의(X2=7.2634.759 P<0.05)；국한성수종조치료유효솔89.3%，미만성수종조치료유효솔68.2%，국한성황반수종조유효솔요명현고우미만성황반수종조。결론 532nm격광치료DR안전유효，조기、급시、유효적격광광응치료시은정병변，강저치맹솔적관건。
Objective To observe the therapeutic effect of 532nm laser photocoagulation on diabetic retinopathy(DR) at different stages. Methods 86 cases of DR diagnosed in 164 eyes, wherein, dysplastic precursor (PPDR) group and 64 eyes, early proliferative phase (stage PDR) group of 58 eyes, high risk hyperplasia period (high PDR) group of 42 eyes, according to the DRPSG (Diabetlc Retinopathy Photocoagulation study Group ) for treatment of technical regulations of photocoagulation and light coagulation parameters of line of standard panretinal photocoagulation (S-PRP) and super panretinal photocoagulation (E-PRP) and macular edema line limitations or grid photocoagulation. Every 3 months the before treatment with the same inspection device and inspection method for visual acuity, ocular fundus, FFA review. Neovascularization has not subsided and non-perfusion residues supplemented with laser photocoagulation. Patients were followed up for 9~18 months, the mean follow-up time of 10.6 months. To the last follow-up observation indices to evaluate the curative effect. Results: the PPDR vision effectively accounted for 81%, effective treatment accounted for 89.1%;PDR vision effectively accounted for 78, effective treatment accounted for 79.3%; high risk PDR vision effectively accounted for 57%, effective 47.6%. In different stages of DR vision therapeutic effective rate had a significant difference (X2=8.200 P<0.05), where PPDR and PDR vision the effective rate of the treatment the difference was not statistically significant (X2=0.251 P>0.05); PPDR, PDR respectively with high risk PDR vision therapeutic effective rate had a significant difference (X2=7.263 4.759 P<0.05); localized edema group, the effective rate of the treatment in 89.3%, diffuse edema of the effective rate of treatment group 68.2%, limited macular edema group was significantly higher than diffuse macular edema group. Conclusion: 532nm laser treatment of DR is safe and effective, early, timely, effective laser photocoagulation is stable lesions, reduce the blindness rate is the key.
