不同分期糖尿病视网膜病变患者采用激光治疗的效果比较
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摘要
目的探讨不同分期糖尿病视网膜病变(DR)激光治疗的临床效果。方法选取我院2016年1月～2017年12月收治的60例(86眼)糖尿病性DR患者,依据眼底荧光素血管造影,将患者分为增殖前期(PPDR组,54眼)与增殖期(PDR组,32眼),每组各30例。两组均采用全视网膜光凝术(PRP)治疗。治疗后,比较两组视野眼底荧光造影(FFA)及视力检查结果。结果术后,PPDR组视力提高28眼(51.85%),PDR组提高9眼(28.13%),PPDR组提高率高于PDR组,差异有统计学意义(χ~2=4.84,P<0.05);经FFA复查得知,PPDR组总有效率(88.89%)高于PDR组(62.50%),差异有统计学意义(χ~2=9.89,P<0.05);两组治疗前后黄斑阈值敏感度变化情况比较,差异无统计学意义(P>0.05),但两组术后中心30°视野平均阈值敏感度显著下降,差异有统计学意义(P<0.05)。结论对糖尿病DR患者开展早期视网膜光凝术,尽管对视野有一定损害,但仍能提高或保持其视功能。
Objective To investigate the clinical effect of laser therapy on diabetic retinopathy(DR) at different stages.Methods 60 patients with diabetic retinopathy(86 eyes) with diabetic retinopathy treated in our hospital from December January 2016 to December 2017 were selected and divided into prophase(group PPDR, 54 eyes) and proliferation period(group PDR, 32 eyes) based on fundus fluorescein angiography, 30 cases in each group. Two groups of patients were treated by total retinal photocoagulation(PRP). After treatment, the fundus fluorescein angiography(FFA) and visual acuity test were compared between the two groups. Results After complete retinal photocoagulation, the visual acuity of group PPDR was increased in 28 eyes(51.85%), group PDR was increased in 9 eyes(28.13%), and the increase rate of group PPDR was higher than that in group PDR(χ2=4.84, P<0.05). The effective rate of PPDR group(88.89%)was higher than that of group PDR(62.50%), and the difference was statistically significant(χ2=9.89, P<0.05); there was no significant difference in the change of the macular threshold sensitivity before and after treatment in the two groups(P>0.05), but the average threshold sensitivity of the 30 degree visual field in the two groups decreased significantly, the difference was statistically significant(P<0.05). Conclusion Early retinal photocoagulation for patients with diabetic retinopathy can improve or maintain visual function, although it has some damage to the visual field.
Objective To investigate the clinical effect of laser therapy on diabetic retinopathy(DR) at different stages.Methods 60 patients with diabetic retinopathy(86 eyes) with diabetic retinopathy treated in our hospital from December January 2016 to December 2017 were selected and divided into prophase(group PPDR, 54 eyes) and proliferation period(group PDR, 32 eyes) based on fundus fluorescein angiography, 30 cases in each group. Two groups of patients were treated by total retinal photocoagulation(PRP). After treatment, the fundus fluorescein angiography(FFA) and visual acuity test were compared between the two groups. Results After complete retinal photocoagulation, the visual acuity of group PPDR was increased in 28 eyes(51.85%), group PDR was increased in 9 eyes(28.13%), and the increase rate of group PPDR was higher than that in group PDR(χ2=4.84, P<0.05). The effective rate of PPDR group(88.89%)was higher than that of group PDR(62.50%), and the difference was statistically significant(χ2=9.89, P<0.05); there was no significant difference in the change of the macular threshold sensitivity before and after treatment in the two groups(P>0.05), but the average threshold sensitivity of the 30 degree visual field in the two groups decreased significantly, the difference was statistically significant(P<0.05). Conclusion Early retinal photocoagulation for patients with diabetic retinopathy can improve or maintain visual function, although it has some damage to the visual field.
引文
[1]苏东升.视网膜激光光凝治疗不同分期糖尿病视网膜病变的疗效分析[J].中国医疗器械信息,2017,23(19):54.
[2]李洪生.532 nm激光治疗不同分期糖尿病视网膜病变的临床疗效观察[J].中国冶金工业医学杂志,2017,34(6):648-649.
[3]闻毅颐,李东豪,徐晖阳.视网膜激光光凝术应用于糖尿病视网膜病变患者不同分期治疗中的临床可行性[J].数理医药学杂志,2016,10(6):95-96.
[4]哈玲芳,杨红燕,赵玉桐,等.激光治疗白内障超乳术后的糖尿病视网膜病变效果分析[J].宁夏医学杂志,2017,39(7):615-617.
[5]胡军华,刘春兰,夏侯梨,等.眼底激光联合羟苯磺酸钙治疗糖尿病视网膜病变的效果观察[J].中国当代医药,2017,24(29):88-90.
[6]司长峰,杨达珍,王佳,等.眼底激光治疗糖尿病视网膜病变的临床研究[J].临床眼科杂志,2016,24(5):407-409.
[7]翁雪燕,陈绵雄,熊青,等.口服降糖药和胰岛素对不同临床分期糖尿病视网膜病变病情进程的影响[J].现代生物医学进展,2017,7(14):2711-2713.
[8]张学印.激光治疗对不同分期糖尿病视网膜病变患者的疗效及预后分析[J].中国基层医药,2017,24(7):1024-1027.
[9]骆晓琴,蒋红文,许娜.532 nm激光治疗DR患者后视力和黄斑水肿的情况分析[J].国际眼科杂志,2017,17(9):1770-1772.
[10]赵颖,戴惟葭,刘大川.糖尿病视网膜病变黄斑厚度及黄斑体积定量分析[J].国际眼科杂志,2017,17(12):2335-2338.
[11]赵弋于,黄荷.不同分期糖尿病视网膜病变患者D-二聚体和血清超敏C反应蛋白水平变化及意义[J].疑难病杂志,2013,12(2):134-136.
[12]陈军锋.激光光凝治疗增殖期糖尿病视网膜病变疗效[J].包头医学院学报,2016,32(6):99-100.
[13]秦平平.眼底激光联合雷珠单抗治疗糖尿病性视网膜病变的临床研究[J].中西医结合心血管病电子杂志,2017,5(17):6-7.
[14]谌金金,严涛.探讨不同分期糖尿病视网膜病变患者多焦视网膜电图及超敏血清C反应蛋白水平变化及意义[J].临床眼科杂志,2017,25(4):299-301.
[15]张磊,刘大川,边俊杰,等.糖尿病视网膜病变激光治疗后视网膜的微细结构变化[J].中国中医眼科杂志,2016,26(5):310-314.
[16]樊利敏,杨波,计青,等非增殖期糖尿病视网膜病变两种分期方法一致性的研究[J].中国当代医药,2017,24(13):115-117.
[2]李洪生.532 nm激光治疗不同分期糖尿病视网膜病变的临床疗效观察[J].中国冶金工业医学杂志,2017,34(6):648-649.
[3]闻毅颐,李东豪,徐晖阳.视网膜激光光凝术应用于糖尿病视网膜病变患者不同分期治疗中的临床可行性[J].数理医药学杂志,2016,10(6):95-96.
[4]哈玲芳,杨红燕,赵玉桐,等.激光治疗白内障超乳术后的糖尿病视网膜病变效果分析[J].宁夏医学杂志,2017,39(7):615-617.
[5]胡军华,刘春兰,夏侯梨,等.眼底激光联合羟苯磺酸钙治疗糖尿病视网膜病变的效果观察[J].中国当代医药,2017,24(29):88-90.
[6]司长峰,杨达珍,王佳,等.眼底激光治疗糖尿病视网膜病变的临床研究[J].临床眼科杂志,2016,24(5):407-409.
[7]翁雪燕,陈绵雄,熊青,等.口服降糖药和胰岛素对不同临床分期糖尿病视网膜病变病情进程的影响[J].现代生物医学进展,2017,7(14):2711-2713.
[8]张学印.激光治疗对不同分期糖尿病视网膜病变患者的疗效及预后分析[J].中国基层医药,2017,24(7):1024-1027.
[9]骆晓琴,蒋红文,许娜.532 nm激光治疗DR患者后视力和黄斑水肿的情况分析[J].国际眼科杂志,2017,17(9):1770-1772.
[10]赵颖,戴惟葭,刘大川.糖尿病视网膜病变黄斑厚度及黄斑体积定量分析[J].国际眼科杂志,2017,17(12):2335-2338.
[11]赵弋于,黄荷.不同分期糖尿病视网膜病变患者D-二聚体和血清超敏C反应蛋白水平变化及意义[J].疑难病杂志,2013,12(2):134-136.
[12]陈军锋.激光光凝治疗增殖期糖尿病视网膜病变疗效[J].包头医学院学报,2016,32(6):99-100.
[13]秦平平.眼底激光联合雷珠单抗治疗糖尿病性视网膜病变的临床研究[J].中西医结合心血管病电子杂志,2017,5(17):6-7.
[14]谌金金,严涛.探讨不同分期糖尿病视网膜病变患者多焦视网膜电图及超敏血清C反应蛋白水平变化及意义[J].临床眼科杂志,2017,25(4):299-301.
[15]张磊,刘大川,边俊杰,等.糖尿病视网膜病变激光治疗后视网膜的微细结构变化[J].中国中医眼科杂志,2016,26(5):310-314.
[16]樊利敏,杨波,计青,等非增殖期糖尿病视网膜病变两种分期方法一致性的研究[J].中国当代医药,2017,24(13):115-117.