激光治疗增殖型糖尿病性视网膜病变的疗效  

Clinical Evaluation of Laser Photocoagulation for Proliferative Diabetic Retinopathy

作　　者：朱彩红[1] 王康孙[1] 张明珩[1] 石海云[1] 

机构地区：[1]上海第二医科大学瑞金医院眼科,上海200025

出　　处：《上海第二医科大学学报》2001年第3期234-237,共4页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：目的　探讨激光治疗增殖型糖尿病性视网膜病变（ＰＤＲ）的疗效。方法　随机应用倍频Ｎｄ：ＹＡＧ激光和砷化镓半导体激光对ＰＤＲ患者行全视网膜光凝术（ＰＲＰ），视网膜任何部位新生血管（ＮＶＥ）给予密集直接光凝，视盘新生血管（ＮＶＤ）不予直接照射。结果　ＰＤＲ患者于ＰＲＰ术后３月６１．５％患眼新生血管消退，１２月７６．２％新生血管消退，ＮＶＤ和ＮＶＥ眼中分别为５８．８％和８８．０％，术后２年以上９４．１％新生血管消退；对ＰＲＰ有成功反应者平均视力有提高。结论　ＰＲＰ对ＰＤＲ有显著疗效，能有效改善和保持患者视力，对ＰＲＰ有成功反应者视力预后较好，ＮＶＥ较ＮＶＤ更容易消退。Objective To assess the efficacy of laser photocogulation to treat proliferative dia- betic retinopathy (PDR). Methods The PDR eyes randomly received panretinal photocoagulation (PRP) with either double - frequence Nd: YAG or diode laser. Neovascularization elsewhere (NVE) was treated with direct and densely covered photocoagulation, while neovascularization of the disc (NVD) was not photocoagulated directly. Results Three months after PRP, a regression of neovas- cularization was seen in 61.5 % of the treated PDR eyes. With a follow - up of twelve months, 76.2% of the treated eyes, 58.8% of NVD eyes and 88.0% of NVE eyes had the neovascularization re- greessed. More than two years after PRP, the proportion of regression was 94.1%. In addition, the prognosis of vision was better in the eyes which successfully responded to PRP. The mean visual acuity improved in these eyes. Conclusion Panretinal photocogulation is an efficient treatment for PDR. The eyes that successfully respond to PRP have a better prognosis for visual acuity. It also suggests that the regression of NVE is easier than that of NVD.

关 键 词：糖尿病视网膜病变 全视网膜光凝术 视网膜新生血管 视盘新生血管 激光疗法 疗效 

分 类 号：R587.1[医药卫生—内分泌]