CAJ | 학술논문

目的探讨中度非增殖期糖尿病性视网膜病变(NPDR)行次全视网膜光凝的疗效,权衡制定上饶地区糖尿病性视网膜病变(DR)的治疗方案.方法选择2006年1月至2013年6月在南昌大学上饶医院眼科门诊经眼底血管造影(FFA)和光学相干断层扫描(OCT)检查诊断的中度非增殖期糖尿病性视网膜病变患者80例(142只眼),并根据病人意愿分为实验组和对照组.实验组40例(70只眼)行次全视网膜激光光凝术,并据FFA结果对黄斑区有微血管渗漏明显的行局部光凝或改良隔栅光凝治疗.对照组40例(72只眼)单纯控制血糖.随访3、6个月、1年和5年,观察患者视力及眼底病变情况.结果 1年以上5年以内,视力下降:实验组为9例17只眼,占24.29％ (17/70),对照组为28例53只眼,占73.61％ (53/72);眼底病变进入增殖前期、增殖期:实验组为7例13只眼(18.57％,13/70),对照组为31例55只眼(76.39％,55/72);实验组与对照组进行组间差异比较,均有统计学意义(视力比较,x2=34.549,P＜0.05;眼底比较x2=47.544,P＜0.05).结论采用激光干预治疗中度非增殖期糖尿病性视网膜病变,可以有效控制糖尿病性视网膜病变进入增殖期,保存有效视力,降低致盲率.
목적 탐토중도비증식기당뇨병성시망막병변(NPDR)행차전시망막광응적료효,권형제정상요지구당뇨병성시망막병변(DR)적치료방안.방법 선택2006년1월지2013년6월재남창대학상요의원안과문진경안저혈관조영(FFA)화광학상간단층소묘(OCT)검사진단적중도비증식기당뇨병성시망막병변환자80례(142지안),병근거병인의원분위실험조화대조조.실험조40례(70지안)행차전시망막격광광응술,병거FFA결과대황반구유미혈관삼루명현적행국부광응혹개량격책광응치료.대조조40례(72지안)단순공제혈당.수방3、6개월、1년화5년,관찰환자시력급안저병변정황.결과 1년이상5년이내,시력하강:실험조위9례17지안,점24.29％ (17/70),대조조위28례53지안,점73.61％ (53/72);안저병변진입증식전기、증식기:실험조위7례13지안(18.57％,13/70),대조조위31례55지안(76.39％,55/72);실험조여대조조진행조간차이비교,균유통계학의의(시력비교,x2=34.549,P＜0.05;안저비교x2=47.544,P＜0.05).결론 채용격광간예치료중도비증식기당뇨병성시망막병변,가이유효공제당뇨병성시망막병변진입증식기,보존유효시력,강저치맹솔.
Objective To discuss on the effective of moderate non-proliferative diabetic retinopathy (NPDR) underwent subtotal-panretinal photocoagulation in order to make plan of therapeutic regimen in Shangrao Prefecture.Methods Clinical data of 80 patients (142 eyes) diagnosed moderate NPDR by examinations of fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) in ophthalmology department of Shangrao hospital of Nanchang university,According to patient own preferences,40 patients (70 eyes) underwent subtotal-panretinal photocoagulation.Presence of edema and exudate in macular by underwent local photocoagulation or modified-macular grid photocoagulation 40 patients (72 eyes) underwent control of blood glucose.BCVA and state of fundus examinations after subtotal-panretinal photocoagulation (3,6,12,70 months) were followed and analyzed.Results After more than 1 year,but less than 5 years,the visual acuity of experimental group decreased in 9 patients (17 eyes) accounted for 24.29％ (17/70),of the control group decreased in 28 patients (53 eyes) accounted for 73.61％ (53/72).Seven patients (13 eyes) in the experimental group entered the proliferation retinopathy,accounted for 18.57％ (13/70),31 patients (55 eyes) in the control group entered the proliferative retinopathy,accounted for 76.39％ (55/72) (P ＜ 0.05).Conclusions The laser treatment of moderate non-proliferative diabetic retinopathy can effectively control the diabetic retinopathy diseases enter proliferative retinopathy,and this method can decrease the rate of blindness.