多波长氪激光治疗不同分期糖尿病视网膜病变  

Multi-wavelength krypton laser photocoagulation for diabetic retinopathy at different stages

作　　者：侯晓映[1] 陈桂文[1] 周伟[1] 周奇鸣[1] 

机构地区：[1]宁波市第二医院眼科,315000

出　　处：《上海医学》2008年第1期18-20,共3页Shanghai Medical Journal

摘　　要：目的探讨多波长氪激光治疗不同分期糖尿病视网膜病变的临床疗效。方法60例110眼糖尿病视网膜病变(DR)患者,其中增殖前期糖尿病视网膜病变(PPDR)18眼,早期增殖期糖尿病视网膜病变(PDR)58眼,高危PDR34眼,依病变程度行次全视网膜光凝术、标准全视网膜光凝术和超全视网膜光凝术。术后随访6～32个月,观察视网膜光凝后患者的视力、眼底及荧光血管造影变化。结果治疗后PPDR患者、早期PDR患者视力提高或不变者分别占88.9%、87.9%,均显著高于高危PDR患者的73.5%(P值均<0.05)。初次视网膜光凝后,PPDR患者、早期PDR患者的有效率分别为94.5%、91.3%,均显著高危PDR患者的41.1%(P值均<0.05)。结论多波长氪激光治疗不同分期糖尿病视网膜病变有效,且PPDR和早期PDR治疗效果好。Objective To evaluate the therapeutic effects of multi-wavelength krypton laser for diabetic retinopathy（DR） at different stages. Methods Sixty patients with DR were enrolled in this study involving 110 eyes, including 18 eyes with preproliferative diabetic retinopathy（PPDR）, 58 with early proliferative diabetic retinopathy （PDR） and 34 with high-risk PDR. According to the severity of the condition, sub-panretinal photoeoagulation, panretinal photocoagulation or extra-panretinal photocoagulation were performed. The patients were followed up for 6-32 months after the operations, and the changes of visual acuity and the findings in fundus examination and fundus fluoreseein angiography（FFA） were assessed. Results The visual acuity were improved or maintained in 16 （88.9%） eyes with PPDR, 52（87. 9%） with early PDR, and 25（73. 5%） with high-risk PDR. After the first treatment session of panretinal photoeoagulation, 94.5% of the eyes with PPDR and 91.3 % with early PDR responded favorably, showing significantly higher favorable response rates than that of the eyes with high-risk PDR （41.1%, P 〈 0.05）. Additional photocoagulation was performed 3 months after the initial session for 2 eyes with PPDR, 23 with early PDR, and 28 with high-risk PDR, and eryotherapy was performed for 1 eye due to neovaseular glaucoma, with another 5 eyes receiving virectomy for vitreous hemorrhage. Conclusion Multi-wavelength krypton laser is effective for management of DR at different stages, and better clinical outcome can be expected from early interventions.

关 键 词：多波长氪激光 糖尿病视网膜病变 全视网膜光凝术 

分 类 号：R779.63[医药卫生—眼科]