视网膜激光治疗糖尿病视网膜病变300例的临床效果

Clinical effect of 300 cases of diabetic retinopathy treated with retinal laser

目的总结分析视网膜激光治疗糖尿病视网膜病变(DR)患者的临床效果。方法选择我院收治的300例(495眼)DR患者,患者均具有完整的术前、术后FFA检查资料。除部分Ⅱ期及个别Ⅲ期患者进行局部视网膜光凝术,其余患者均实施全视网膜激光光凝术治疗。分析视网膜激光的治疗效果。结果300例DR患者(495眼)经激光治疗后,共436眼(88.08%)获得了较为满意的治疗效果。其中,有301眼术后视力提高至术前的2行或不再下降,占69.04%(301/436),主要分布于Ⅱ、Ⅲ期患者;379眼术后眼底视网膜水肿、出血、渗出等全部吸收或部分吸收,占86.93%(379/436);383眼术后视网膜新生血管全部消退或大部分消退,占87.84%(383/436)。纳入的V期DR患者(25眼)中,有1例患者术后发生玻璃体积血,其他患者无严重并发症。436眼治疗效果满意,患者术后6个月的平均视力较治疗前显著改善,差异显著(P<0.05)。结论视网膜激光治疗DR具有较好的临床效果,临床应根据患者病情和病变部位选择适宜的激光方法,尽早治疗。

Objective To summarize and analyze the clinical effect of retinal laser in the treatment of patients with diabetic retinopathy (DR). Methods Three hundreds patients (495 eyes) with DR admitted in our hospital were selected. All patients had complete data of FFA examination before and after operation. In addition to partial retinal photocoagulation in stage Ⅱ and individual stage Ⅲ patients, the rest of the patients were treated with total retinal laser photocoagulation. The therapeutic effect of retinal laser was analyzed. Results After laser treatment, 436 eyes (88.08%) of 300 DR (495 eyes) patients achieved satisfactory results. Among them, the visual acuity of 301 eyes improved to 2 rows or did not decrease after operation, accounting for 69.04%(301/436) and mainly in stage Ⅱ and Ⅲ patients;in 379 eyes, retinal edema, hemorrhage and exudation were absorbed or partially absorbed, accounting for 86.93%(379/436);in 383 eyes, retinal neovascularization disappeared or mostly disappeared, accounting for 87.84%(383/436). Among the DR patients in stage V (25 eyes), 1 patient had vitreous hemorrhage after operation, and the other patients had no serious complications. The average visual acuity of 436 eyes with satisfactory therapeutic effect at 6 months after operation significantly improved compared with that before treatment (P<0.05). Conclusion Retinal laser in the treatment of DR has a good clinical effect. In clinic, the appropriate laser method should be selected according to the patients' condition and lesion location and given treatment as soon as possible.