CAJ | 학술논문

目的：观察雷珠单抗( ranibizumab)玻璃体腔内注射联合复方樟柳碱颞浅动脉旁皮下注射联合黄斑格栅样光凝治疗糖尿病黄斑水肿的临床疗效。方法确诊为糖尿病黄斑水肿的患者68例112眼，其中单眼30例，双眼38例，随机分为两组：一组为单纯激光光凝治疗组（简称单纯光凝组）56眼，另一组先行雷珠单抗玻璃体腔内注射联合复方樟柳碱颞浅动旁皮下注射，再于注药1周后行黄斑格栅样光凝（简称联合组）56眼。观察两组治疗后最佳矫正视力( BCVA)，光学相干断层扫描( OCT)显示的黄斑中心凹厚度( CMT)及术后并发症等。结果联合治疗组视力提高47眼（83.9%），视力不变6眼（10.7%），视力下降3眼（5.4%）。水肿吸收53眼（94.6%），水肿未退3眼（5.4%）。单纯光凝治疗组视力提高13眼（23.2%），视力不变31眼（55.4%），视力下降12眼（21.4%）。水肿吸收18眼（32.1%），水肿未退38眼（67.9%）。结论雷珠单抗玻璃体腔内注射联合复方樟柳碱颞浅动脉旁皮下注射可促进黄斑囊水肿的吸收，提高患者视力，降低黄斑中心凹厚度，联合黄斑格栅样光凝治疗更能保证疗效稳定而持久。
목적：관찰뢰주단항( ranibizumab)파리체강내주사연합복방장류감섭천동맥방피하주사연합황반격책양광응치료당뇨병황반수종적림상료효。방법학진위당뇨병황반수종적환자68례112안，기중단안30례，쌍안38례，수궤분위량조：일조위단순격광광응치료조（간칭단순광응조）56안，령일조선행뢰주단항파리체강내주사연합복방장류감섭천동방피하주사，재우주약1주후행황반격책양광응（간칭연합조）56안。관찰량조치료후최가교정시력( BCVA)，광학상간단층소묘( OCT)현시적황반중심요후도( CMT)급술후병발증등。결과연합치료조시력제고47안（83.9%），시력불변6안（10.7%），시력하강3안（5.4%）。수종흡수53안（94.6%），수종미퇴3안（5.4%）。단순광응치료조시력제고13안（23.2%），시력불변31안（55.4%），시력하강12안（21.4%）。수종흡수18안（32.1%），수종미퇴38안（67.9%）。결론뢰주단항파리체강내주사연합복방장류감섭천동맥방피하주사가촉진황반낭수종적흡수，제고환자시력，강저황반중심요후도，연합황반격책양광응치료경능보증료효은정이지구。
Objective To observe the clinical effect of intravitreal lucentis combined with compound anisodine hydrobromide and laser photocoagulation on the treatment of diabetic macular edema. Methods Sixty-eight patients (112eyes) who were diagnosed with diabetic macular edema by ocular-fundus examination and fundus fluorescein angiography (FFA) were chosen. Fifty of them were treated with only laser photocoagulation and others were treated with intraviatreal lucentis combined with compound anisodine hydrobromide and laser photocoagulation. Visual BCVA, CMT and postoperative complications were observed. Results Among patients with intravitreal lucentis combined compound anisodine hydrbromide ,the case of visual cure was 47 (83.9%), the case of visual improvement was 2 or more, no change is 6 (10.7) visual decrease is 3 patients (5.4%). Edema in 53 patients (86.8%) reduced after treatment. Among patients with laser phptocoagulation, the case of visual recovery in 13 (23.2%), 31 patients had no change (55,4%) , 12 patients (21.4%) had a visual decrease. Edema in 18 patients (32.1%) reduced after treatment. Conclusion The cure effect of intravitreal lucentis combined with compound anisodine hydrobromide and laser photocoagulation is better than those of only using laser photocoagulation.