中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2009年
9期
48-49
,共2页
全网膜光凝术%糖尿病视网膜病变
全網膜光凝術%糖尿病視網膜病變
전망막광응술%당뇨병시망막병변
Panreteinal photocoagulation%Diabetic retinopathy
目的 观察不同分期糖尿病视网膜病变(DR)全视网膜光凝的疗效及预后分析.方法 根据DRPS(Diabetic Retinopathy Photocoagulation study Group)制订的治疗技术规定,对135例216眼分别为增殖前期糖尿病视网膜病变(PPDR)、增殖期糖尿病视网膜病变(PDR)行全视网膜光凝治疗,按技术规定的光凝范围和光凝参数行次全网膜光凝(Sub-PRe)、标准全网膜光凝(S-PRP)和超全网膜光凝(EPRP),术后3个月,6个月,12个月行FFA及彩色眼底像,新生血管未消退和无灌注区尚存者追加光凝,随访3～48个月.结果 PPDR视力提高和不变占133眼(82.5%),高危PDR视力提高和不变占34眼(61.9%).经过一次全网膜光凝后,PPDR有效率为142眼(88.2%),PDR有效率为36眼(65.5%).3个月后复查FFA,NV未消失者追加光凝19眼(11.8%),但仍有15眼(9.3%)进展为PDR;PDR一次或多次追加光凝35眼(63.6%),最终仍有20眼(36.4%)行玻璃体切割术.结论 不同分期DR全网膜光凝术后预后不同,选择合适时机和合理的激光参数对不同分期DR进行全视网膜光凝术是确保DR视力稳定的关键.
目的 觀察不同分期糖尿病視網膜病變(DR)全視網膜光凝的療效及預後分析.方法 根據DRPS(Diabetic Retinopathy Photocoagulation study Group)製訂的治療技術規定,對135例216眼分彆為增殖前期糖尿病視網膜病變(PPDR)、增殖期糖尿病視網膜病變(PDR)行全視網膜光凝治療,按技術規定的光凝範圍和光凝參數行次全網膜光凝(Sub-PRe)、標準全網膜光凝(S-PRP)和超全網膜光凝(EPRP),術後3箇月,6箇月,12箇月行FFA及綵色眼底像,新生血管未消退和無灌註區尚存者追加光凝,隨訪3～48箇月.結果 PPDR視力提高和不變佔133眼(82.5%),高危PDR視力提高和不變佔34眼(61.9%).經過一次全網膜光凝後,PPDR有效率為142眼(88.2%),PDR有效率為36眼(65.5%).3箇月後複查FFA,NV未消失者追加光凝19眼(11.8%),但仍有15眼(9.3%)進展為PDR;PDR一次或多次追加光凝35眼(63.6%),最終仍有20眼(36.4%)行玻璃體切割術.結論 不同分期DR全網膜光凝術後預後不同,選擇閤適時機和閤理的激光參數對不同分期DR進行全視網膜光凝術是確保DR視力穩定的關鍵.
목적 관찰불동분기당뇨병시망막병변(DR)전시망막광응적료효급예후분석.방법 근거DRPS(Diabetic Retinopathy Photocoagulation study Group)제정적치료기술규정,대135례216안분별위증식전기당뇨병시망막병변(PPDR)、증식기당뇨병시망막병변(PDR)행전시망막광응치료,안기술규정적광응범위화광응삼수행차전망막광응(Sub-PRe)、표준전망막광응(S-PRP)화초전망막광응(EPRP),술후3개월,6개월,12개월행FFA급채색안저상,신생혈관미소퇴화무관주구상존자추가광응,수방3～48개월.결과 PPDR시력제고화불변점133안(82.5%),고위PDR시력제고화불변점34안(61.9%).경과일차전망막광응후,PPDR유효솔위142안(88.2%),PDR유효솔위36안(65.5%).3개월후복사FFA,NV미소실자추가광응19안(11.8%),단잉유15안(9.3%)진전위PDR;PDR일차혹다차추가광응35안(63.6%),최종잉유20안(36.4%)행파리체절할술.결론 불동분기DR전망막광응술후예후불동,선택합괄시궤화합리적격광삼수대불동분기DR진행전시망막광응술시학보DR시력은정적관건.
Objective To observe the of panretinal photocoagulation for diabetic retinopathy of different staging.Methods According the treatment technique stipulations formulated by DRPSG(Diabetic Retinopathy Photocoagulation study Group),216 eyes in 135 cases respectively suffering form preproliferrative diabetic retinopathy(PPDR),proliferative diabetic retinopathy (PDR) were treated with panretinal photocoagulation.These patients were received the treatment of subpanretinal photocoagulation (Sub-PRP),standard panretinal photocoagulation(S-PRP) and extra panretonal photocoagulation (E-PRP).All these treatment were performed with the range and parameters provided by the treatment technique stipulations.The Fundus Fluorescein Angiography(FFA) and color photograph were taken 3 m,6 m and 12 m after the treatmemt.For those cases with remaining new vessels and non-perfusion areas,the treatment was complemented with further photocoagulation.The folllowup period was 3-48 months.Results Visual acuity were improved or maintained in 133 eyes(82.5%) in group of PPDR,34eyes(61.9% ) in group if high risk PDR.After one time panretinal photooagution,the effective rate was 142 eyes(88.2%) in group of PPDR,36 eyes(65.5%) in group of high risk RDR.For those cases with remaining new vessels and non-perfusion areas,the treatment was complemented with further photocoagulation in 3 m after the first treatment.The cases with further photocoagulation were 19 eyes(11.8% )in group of PPDR,hut there were 15 eyes (9.3% )to develop to PDR.The cases with further photocoagulation were 35eye (63.6%) in group of PDR,there were 20 eyes(36.4%)to underwent vitrectomy.Conclusion The prognosis of diabetic retinopathy of different staging is different after panreteinal photocoagulation.It's very important to choice suitable occasion and reasonable parameters for panretinal photocoagulation for patients with diabetic retinopathy to ensuee visual acuity maintaining.
