视网膜光凝治疗糖尿病性视网膜病变3596例疗效观察与分析
Therapeutic Effect of Photocoagulation on Different Stages of Diabetic Retinopathy through Review of 3596 Cases
DOI: 10.12677/HJO.2018.73019, PDF,   
作者: 林 延*, 苏淑娟, 张 晟：厦门大学附属第一医院眼科，福建 厦门
关键词: 糖尿病；视网膜病变；激光；视网膜光凝治疗；Diabetes； Diabetic Retinopathy； Laser； Photocoagulation
摘要: 目的：分析评价视网膜光凝对不同分期糖尿病性视网膜病变治疗的疗效。方法：对2005~2015年间在我院门诊进行视网膜光凝治疗的不同分期的3596例糖尿病性视网膜病变患者的治疗效果进行回顾性分析，以视力是否改善(维持或提高≥0.1)、黄斑水肿是否好转或消失、眼底血管荧光造影眼底病变有否改善、新生血管消失渗漏减少为治疗有效标准。结果：视网膜光凝治疗不仅对病程进展后期的增殖期(Proliferative diabetic retinopathy, PDR)或增殖前期(Pre-proliferative diabetic retinopathy, PPDR)患眼有明显的治疗效果，治疗后视力有所提升或稳定的病人达75.0% (PDR)~80.3% (PPDR)，结合黄斑水肿的消退及眼底血管病变改善等指标，治疗综合有效率分别达到87.1% (PDR)和85.2% (PPDR)，并且对非增殖期(Non-proliferative diabetic retinopathy, NPDR)患者的光凝治疗也达到延缓病程发展的作用，综合有效率达82.3%。对PDR及PPDR进行全视网膜光凝治疗辅以血管活化药物昊畅胶囊或中药复方血栓通胶囊及和血明目片，有助视网膜病变修复。结论：应用视网膜光凝治疗对不同分期的糖尿病性视网膜病变都有明显的治疗效果，能够延缓病程的发展，有助于视力的保护。
Abstract: Objective: To evaluate the therapeutic effect of photocoagulation on different stages of diabetic retinopathy (DR). Methods: A total of 3596 patients diagnosed with DR, including 1231 cases of non-proliferative DR (NPDR), 1312 cases of pre-proliferative DR (PPDR) and 1053 cases of prolif-erative DR (PDR) were treated with retinal photocoagulation. The therapeutic effects were evalu-ated by the visual improvement, reduced retinol blood vessel damage measured by optical coher-ence tomography (OCT), ophthalmoscopy and fluorescence fundus angiography (FFA). Results: The therapeutic effects of retinol photocoagulation have been observed in all stages of DR patients characterized by improved or stable visual ability, reduced retinol edema and bleeding. The total effective rates of photocoagulation for NPDR, PPDR and PDR patients were 82.3%, 85.2% and 87.1%, respectively. The better effective rate on PPDR and PDR patients may be related to the supplementary use of calcium dobesilate or modified Chinese medicines (Xue Shuan Tong or He Xue Ming Mu) that improve blood circulation. Conclusion: Retinol photocoagulation has therapeutic effects on all stages of DR.
文章引用：林延, 苏淑娟, 张晟. 视网膜光凝治疗糖尿病性视网膜病变3596例疗效观察与分析[J]. 眼科学, 2018, 7(3): 127-132. https://doi.org/10.12677/HJO.2018.73019

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