多波长氪激光治疗糖尿病视网膜病变的观察  

Prognosis of the multiwavelength krypton lasers in treatment of diabetic retinopathy

作　　者：胡汝平 

机构地区：[1]驻马店市第一人民医院眼科,河南463000

出　　处：《中华眼外伤职业眼病杂志》2014年第6期467-470,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的 探讨多波长氪离子激光治疗糖尿病视网膜病变的长期疗效.方法 对278例（451眼）分为非增生性糖尿病视网膜病变（NPDR）,增生前期糖尿病视网膜病变（PPDR）,增生性糖尿病视网膜病变（PDR）.行局部、象限、广泛视网膜光凝或超广泛视网膜光凝治疗.分别于激光治疗前、激光治疗后3个月、6个月、12个月、24个月随访,行视力、眼压、散瞳后眼底检查、荧光眼底血管造影（FFA）.复查时如发现仍有毛细血管渗漏、无灌注区或新生血管未消退者则追加光凝.结果 NPDR随访2年,218眼（86.1％）视力稳定,其中5眼发生玻璃体积血,随访期间均逐渐吸收好转.PPDR随访2年,93眼（74.4％）视力稳定,其中有2眼因玻璃体积血难以吸收而接受玻璃体切除手术.PDR随访2年,40眼（54.8％）视力稳定,4眼因玻璃体积血难以吸收而行玻璃体手术.光凝可以减少玻璃体积血的发生,也有助于玻璃体内积血不能吸收的患者进行手术治疗.结论 应根据糖尿病视网膜病变的严重程度,选择合适的激光治疗方式,病情较轻、原视力较好者预后较好.Objective To investigate the long term effects of multiwavelength krypton lasers for diabetic retinopathy.Methods A total of 451 eyes of 278 cases suffering from nonproliferative diabetic retinopathy（NPDR）,preproliferative diabetic retinopathy （PPDR）and proliferative diabetic retinopathy （PDR） were treated with local,quadrantal,panretinal photocoagulation or extra panretinal photocoagulation.Visual acuity, intraocular pressure,fundus examination and fundus fluorescein angiography were performed before photocoagulation and 3,6,12 and 24 months after photocoagulation.Eyes with remaining leakage of dye from abnormal vessels,non-perfusion areas or neovascularization were complemented with further photocoagulation.Results During the 2-year follow up,in NPDR group,218 eyes （86.1%） got stable visual acuity,5 eyes had the vitreous haemorrhages,and it were gradually absorbed.In PPDR group,93 eyes got stable vision （74.4%）,2 eyes were treated with vitrectomy due to vitreous haemorrhages.In PDR group,40 eyes （54.8%） got stable vision,4 eyes were treated with vitrectomy,Photocoagulation can reduce the possibilities of vitreous haemorrhage and was helpful for vitrectomies.Conclusion Appropriate photocoagulation techniques should be selected due to the severity of diabetic retinopathy.Cases with less severe,good visual acuity have the favourable outcome.

关 键 词：激光 多波长 氪离子 光凝 视网膜 广泛 视网膜病变 糖尿病 

分 类 号：R587.2[医药卫生—内分泌]