糖尿病视网膜病变患者激光治疗后疼痛反应研究

目的观察糖尿病视网膜病变患者行眼底氪激光治疗后的疼痛反应。方法对我院门诊糖尿病视网膜病变患者60人68只眼进行激光光凝治疗,根据光凝部位分成全视网膜光凝组（颞上、颞下、鼻上、鼻下）和黄斑区光凝组,根据视网膜病变程度分成BDR-Ⅲ组、PDR-Ⅳ组和PDR-Ⅴ组。光凝治疗后应用视觉模拟评分法（visual analogue scale,VAS）对疼痛反应进行评估,比较各组的疼痛反应。结果全视网膜光凝组激光治疗后颞上、颞下、鼻上、鼻下4个象限之间的疼痛反应无明显差异（P〉0.05）,黄斑区光凝组的疼痛反应则明显高于全视网膜光凝组（P〈0.05）。PDR-Ⅳ组和PDR-Ⅴ组的疼痛反应高于BDR-Ⅲ组（P〈0.05）,而PDR-Ⅳ组和PDR-Ⅴ组之间疼痛反应无明显差异（P〉0.05）。结论医生在行激光治疗时应根据糖尿病视网膜病变的部位、病变严重程度及患者对激光的疼痛反应而适当调整激光能量及治疗方案,达到有效的治疗目的。

Clinical study of pain reaction of diabetic retinopathy patients after laser treatment

OBJECTIVE To observe the pain reaction of diabetic retinopathy patients after laser treatment.METHODS Sixty cases（68 eyes） with diabetic retinopathy were treated by laser.According to the position of diabetic retinopathy,cases were divided into panretinal photocoagulation group（temple-superior,temple-inferior,nasal-superior nasal-inferior） and macula group.According to the severity of diabetic retinopathy,cases were divided into background diabetic retinopathy-Ⅲ（BDR-Ⅲ）group,proliferative diabetic retinopathy-Ⅳ（PDR-Ⅳ） group and proliferative diabetic retinopathy-Ⅴ（PDR-Ⅴ） group.Patients were evaluated after laser treatment by visual analogue scale（VAS）.RESULTS The differences of pain reaction among temple-superior group,temple-inferior group,nasal-superior group and nasal-inferior group were not statistically significant（P0.05）.The difference of pain reaction between panretinal photocoagulation group and macula group was statistically significant（P0.05）.The pain in BDR-Ⅲ group was less than that of PDR-Ⅳ group and PDR-Ⅴgroup,and the difference was significant（P0.05）.The pain reaction between PDR-Ⅳ group and PDR-Ⅴgroup was the same（P0.05）.CONCLUSIONS In order to obtain effective treatment purposes,laser treatment and energy adjustment should be based on the position,severity of diabetic retinopathy and the patient＇s pain response to the laser.