糖尿病视网膜病变激光治疗临床分析  

The therapeutie, effects of the laser treatment for diabetic retinopathy

作　　者：贾延磊[1] 

机构地区：[1]山东省枣庄市立医院眼科,277100

出　　处：《中国临床实用医学》2009年第9期48-49,共2页China Clinical Practical Medicine

摘　　要：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—PRP）、标准全网膜光凝（S-PRP）和超全网膜光凝（E-PRP），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。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 treatmernt. 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, but 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.

关 键 词：全网膜光凝术 糖尿病视网膜病变 

分 类 号：R77[医药卫生—眼科] R587[医药卫生—临床医学]