多点扫描与单点模式全视网膜激光光凝术治疗重度非增生期糖尿病视网膜病变患者的效果对比  

Comparison of effect of multi-point scanning and single-point model pan retinal photocoagulation in treating patients with severe non-proliferative diabetic retinopathy

作　　者：陈德兵 殷俏 邓才峰 CHEN Debing;YIN Qiao;DENG Caifeng(Department of Ophthalmology,The First Affiliated Hospital of Jiangxi Medical College,Shangrao,334000,Jiangxi,China)

机构地区：[1]江西医专第一附属医院眼科,江西上饶334000

出　　处：《当代医学》2024年第15期34-38,共5页Contemporary Medicine

摘　　要：目的探讨多点扫描与单点扫描模式全视网膜激光光凝术(PRP)治疗重度非增生期糖尿病视网膜病变(NPDR)患者的临床效果。方法选取2023年1月至2023年6月江西医专第一附属医院收治的50例(97眼)重度NPDR患者作为研究对象,按照随机数字表法分为实验组(n=25,48眼)与对照组(n=25,49眼)。实验组给予多点扫描模式PRP,对照组给予单点扫描模式PRP。比较两组临床疗效,治疗前后视野平均阈值(MS)、黄斑中心凹厚度(CMT)、闪光视网膜电流图(F-ERG)a波与b波、平均视网膜神经纤维层厚度(RNFL)、激光能量、光斑数量、能量密度及术后并发症发生情况。结果两组临床疗效及治疗总有效率比较差异无统计学意义。治疗后1 d、1个月时,两组MS均小于治疗前,CMT均大于治疗前,差异有统计学意义(P<0.05);治疗前及治疗后1 d、治疗后1个月,两组MS、CMT比较差异均无统计学意义。治疗后1 d,两组F-ERG a波、b波均小于治疗前,但实验组大于对照组,差异有统计学意义(P<0.05);治疗后1个月,两组F-ERG b波小于治疗前,差异有统计学意义(P<0.05);治疗前、治疗后1个月,两组F-ERG a波、b波比较差异无统计学意义。治疗后1个月,两组平均RNFL均小于治疗前,差异有统计学意义(P<0.05);治疗前、治疗后1个月,两组平均RNFL比较差异无统计学意义。实验组激光能量高于对照组,能量密度低于对照组,差异有统计学意义(P<0.05);两组光斑数量比较差异无统计学意义。两组视网膜前出血、玻璃体积血、玻璃体视网膜增生发生率比较差异无统计学意义。结论不同模式PRP治疗NPDR患者均可取得良好的临床效果,但多点扫描激光对周边视野、视网膜光感受器及内核细胞层损伤更小,在促进治疗后视力恢复方面相较单点模式更具优势。Objective To explore the clinical effect of multi-point scanning and single-point scanning model pan retinal photocoagulation(PRP)in the treatment of patients with severe non-proliferative diabetic retinopathy(NPDR).Methods 50 patients(97 eyes)with severe NPDR admitted to the First Affiliated Hospital of Jiangxi Medical College from January 2023 to June 2023 were selected as the research subjects,they were divided into the experimental group(n=25,48 eyes)and the control group(n=25,49 eyes)according to the random number table method.The experimental group was given multi-point scanning model PRP,while the control group received single-point scanning model PRP.The clinical efficacy,mean visual field threshold(MS),central macular thickness(CMT),flash electroretinogram(F-ERG)a wave and b wave,mean retinal nerve fiber layer thickness(RNFL),laser energy,spot count and energy density before and after treatment and postoperative complications were compared between the two groups.Results There were no statistical differences in clinical efficacy and total effective rate of treatment between the two groups.At 1 d and 1 month after treatment,MS of the two groups was lower than that before treatment,while CMT was higher than that before treatment,the differences were statistically significant(P<0.05);there was no significant difference in the MS and CMT between the two groups before treatment,1 d and 1 month after treatment.At 1 d after treatment,a wave and b wave of F-ERG of the two groups were lower than those before treatment,but the experimental group was higher than the control group,the differences were statistically significant(P<0.05);at 1 month after treatment,F-ERG b wave of the two groups were lower than that before treatment,the differences were statistically significant(P<0.05);there were no statistical differences in a wave and b wave of F-ERG between groups before treatment and at 1 month after treatment.At 1 month after treatment,The average RNFL of the two groups were lower than that before treatment,the dif

关 键 词：全视网膜激光光凝术 多点扫描模式激光 单点扫描模式激光 非增生期糖尿病视网膜病变 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]