532nm绿激光格栅样光凝联合球内注药治疗糖尿病视网膜病变黄斑水肿  

532 nm green grid laser photocoagulation combined with intravitreal Avastin injection for diabetic retinopathy macular edema

作　　者：魏光杰[1] 何佃菊[2] 

机构地区：[1]莱芜市人民医院眼科,山东省莱芜市271100 [2]莱芜市人民医院内分泌科,山东莱芜市271100

出　　处：《眼科新进展》2014年第8期779-781,共3页Recent Advances in Ophthalmology

摘　　要：目的观察532 nm绿激光格栅样光凝联合球内注药治疗糖尿病视网膜病变(diabetic retinopathy,DR)黄斑水肿的临床疗效。方法选择2011年1月至2012年12月我院收治的DR黄斑水肿患者40例(80眼),随机分为治疗组和对照组,每组20例,对照组给予单纯532 nm绿激光格栅样光凝术,治疗组在532 nm绿激光格栅样光凝术前给予球内注射Avastin(美国Genentech公司)。随访期末采用眼底镜及FFA观察患者眼底改变情况,采用国际标准视力表检查患者治疗前后视力,同时使用光学相干断层扫描仪检查患者治疗前后的黄斑区视网膜厚度。结果治疗组治愈22眼,显效16眼,无效2眼,总有效率为95.0%;对照组治愈17眼,显效16眼,无效7眼,总有效率为82.5%;经统计学分析,两组患者的总有效率差异有统计学意义(P<0.05),治疗组疗效好于对照组。治疗前视力比较,两组差异无统计学意义(P>0.05);与治疗前视力相比,治疗后视力均显著提高(均为P<0.05);治疗后视力组间比较,治疗组视力好于对照组(P<0.05)。治疗组和对照组治疗前黄斑区视网膜厚度分别为(425.44±38.23)μm、(437.66±36.12)μm,两组间差异无统计学意义(P>0.05);治疗后黄斑区视网膜厚度分别为(165.28±25.64)μm、(275.78±42.14)μm,较治疗前均降低(均为P<0.05),且治疗组低于对照组(P<0.05)。结论相对于单纯激光光凝术,532 nm绿激光格栅样光凝联合球内注药治疗DR更加安全有效,术后视力恢复更快,黄斑水肿吸收更好。Objective To discuss the clinical efficacy of 532 nm green grid laser photocoagulation combined with intravitreal Avastin injection for diabetic retinopathy（ DR） macular edema.Methods Forty patients（ 80 eyes） with DR macular edema in our hospital from January 2011 to December 2012 were chosen and divided into two groups, 20 cases in each group,the treatment group received the 532 nm green grid laser photocoagulation combined with intravitreal Avastin injection, and the control group with single 532 nm green grid laser photocoagulation,the postoperative fundus changes were observed by FFA and fundus photography,the visual acuity was checked, and the macular retinal thickness was detected by OCT. Results In the treatment group,the edema was cured in 22 eyes, effective in 16 eyes, ineffective in 2 eyes,the total effective rate was 95. 0%; In the control group,the edema was cured in 17 eyes, effective in 16 eyes, ineffective in 7 eyes,the total effective rate was 95. 0%; Statistical difference was found between two groups（ P ＆lt; 0. 05）. There was no difference in preoperative visual acuity between two groups（ P＆gt; 0. 05）,the postoperative visual acuity in two groups all increased（ all P ＆lt; 0. 05）,the experiment group was better than the control group（ P ＆lt; 0. 05）. The preoperative macular retinal thickness of two groups were（ 425. 44 ± 38. 23） μm,（ 437. 66 ± 36. 12） μm,which after operation were（ 165. 28 ± 25. 64） μm,（ 275. 78 ± 42. 14） μm, statistical difference was found between two group in postoperative macular retinal thickness（ P ＆lt; 0. 05）. Conclusion Compared with the single 532 nm green grid laser photocoagulation,t he 532 nm green grid laser photocoagulation combined with intravitreal Avastin injection for DR macular edema is more effective and afe with better postoperative visual acuity recovery.

关 键 词：糖尿病视网膜病变 黄斑水肿 格栅样光凝 AVASTIN 

分 类 号：R587.2[医药卫生—内分泌]