光凝联合药物治疗糖尿病性黄斑水肿

Diabetic Macular Edema Treated with Photocoagulation and Medication

目的观察多波长激光光凝联合药物治疗糖尿病性黄斑水肿的治疗效果,评价视网膜光凝结合药物治疗糖尿病性黄斑水肿的疗效。方法根据荧光素眼底血管造影选择糖尿病性黄斑水肿患者106例(170眼),随机分为1、2两组。两组患者均接受了视网膜光凝治疗,其中2组58例(96眼)在光凝治疗基础上服用中药,中重度水肿者联合球后注射曲氨萘德。治疗前后检查两组患者视力、眼底和眼底荧光血管造影。结果根据患者视力和黄斑水肿情况,对两组疗效进行比较,光凝联合药物治疗组较单纯光凝组视力改善明显,黄斑水肿吸收较单纯光凝组快,总有效率为47.9%,高于单纯光凝组的31.1%,两组疗效差异有统计学意义(P<0.05)。结论视网膜光凝治疗糖尿病性黄斑水肿时联合服用中药,严重者配合注射曲氨萘德较单纯应用光凝治疗效果更好。

Objective To observe the efficacy on diabetic macular edema treated with multi-wave length photocoagulation and medication and assess the efficacy of panretinal photocoagulation and medication on the disease.Methods Fundus fluorescent angiography was adopted to select 106 cases（170 eyes）of diabetic macular edema and randomize them into No.1 and No.2 groups.All the cases in two groups accepted panretinal photocoagulation therapy.Of them,58 cases（96 eyes）in No.2 groups were also treated with herbal medication on the basis of panretinal photocoagulation.For the cases with moderate to serious edema,retrobulbar injection of triamcinolone acetonide was combined.The vision,eye fundus and fundus fluorescent angiography were examined before and after treatment for the patients.Results According to the vision and macular edema situation of the patients,the efficacy was compared between two groups.As compared with simple photocoagulation group,in photocoagulation plus medication group,the vision was improved obviously,and the total effective rate was 47.9% that was higher than 31.1% in simple photocoagulation group.The efficacy was different significantly between two groups（P0.05）.Conclusion The panretinal photocoagulation achieves a better efficacy on diabetic macular edema in combination with herbal medication and the injection of triamcinolone acetonide involved for the serious cases,as compared with simple photocoagulation therapy.