激光光凝对糖尿病视网膜病变的疗效

Curative effect of laser photocoagulation for diabetic retinopathy

目的探讨激光光凝对糖尿病视网膜病变（DR）的治疗效果。方法选择2011年1月~2014年6月南方医科大学附属柳州医院收治的进行视网膜激光光凝治疗的DR患者103例（187眼）,对其视力改善情况进行随访。结果随访时间为4~24个月,平均12个月。其中26眼（13.90%）视力提高,137眼（73.26%）视力未见明显变化,24眼（12.84%）视力下降。通过眼底荧光素血管造影检查显示,166眼的视网膜水肿情况减轻,视网膜病变得到不同程度的控制,出血、渗出减少,视网膜无灌注区及新生血管部分或全部消退,治疗总有效率为88.77%。糖化血红蛋白（Hb A1c）水平〈8%组患者视力改善情况优于Hb A1c≥8%组患者,差异有统计学意义（χ^2=15.61,P〈0.05）,增殖前期患者接受激光光凝术后视力改善情况优于增殖期患者,差异有统计学意义（χ^2=7.91,P〈0.05）。结论采用激光光凝治疗DR安全有效,可保护眼视功能,其疗效与血糖控制情况及临床分期有关。

Objective To investigate the therapeutic effect of laser photocoagulation on diabetic retinopathy（DR） and identify the control effect of serum glucose. Methods 103 patients with DR from January 2011 to June 2014 treated in the Liuzhou Municipal Liutie Central Hospital by laser photocoagulation were selected and made regular follow-up. A total of 187 eyes were followed up for their vision. Results The total follow-up time was 4-24 months, average 12 months. There were 26 eyes（13.90%） owned significant vision improvement and 137 eyes（73.26%） had no significant change of vision. The vision on other 24 eyes（12.84%） was decreased. There were 166 eyes of retinal lesions have different degrees of control. Ophthalmoscope detection showed that the retinal edema reduced and reduced neovascularization. The total effective rate of laser photocoagulation therapy was 88.77%. Vision improvement of patients in Hb A1c8% group was better than those of Hb A1c≥8% group, the difference was statistically significant（χ^2=15.61,P〈0.05）, vision improvement condition of patients who were given laser photocoagulation in proliferative diabetic retinopathy were better than those treated with laser photocoagulation in proliferating phase, the difference was statistically significant（χ^2=7.91,P〈0.05）. Conclusion Laser photocoagulation is both safe and effective in the treatment of DR, and the curative effect is related to control situation of blood glucose and clinical staging.