氪黄激光联合曲安奈德治疗糖尿病弥漫性黄斑水肿的临床疗效观察

目的　探讨氪黄激光联合曲安奈德治疗糖尿病弥漫性黄斑水肿的临床疗效。方法　糖尿病弥漫性黄斑水肿患者６５例（８０眼）按照就诊时间的顺序分为治疗组与对照组各４０眼，两组均应用氪黄激光进行黄斑区格栅样光凝，需行全视网膜光凝者在黄斑格栅样光凝后进行，在此基础上治疗组给予曲安奈德治疗。结果　治疗组与对照组的有效率分别为９５．０％和８５０％，组间比较差异有统计学意义（Ｐ＜０．０５）。治疗前视网膜厚度治疗组为（６３２．２５±９１．２５）μｍ，对照组为（６３５．２１±１７２５）μｍ，两组差异无统计学意义（Ｐ＝０．６９６），治疗后都有明显下降，分别为（２７６．２５±１７．６２）μｍ和（３１２．５２±９３．１２）μｍ，同时期组间比较差异有统计学意义（Ｐ＜０．０５）。两组治疗前视力对比无明显差异，治疗后１个月与治疗后３个月都有明显提高，同时期组间比较差异无统计学意义（Ｐ＞０．０５）。治疗组与对照组的渗漏消失率分别为５２．５％和３７．５％，组间比较差异有统计学意义（Ｐ＜００５）。结论　氪黄激光联合曲安奈德治疗糖尿病弥漫性黄斑水肿能有效提高综合疗效，降低视网膜厚度及荧光渗漏。

Krypton yellow laser combined with triamcinolone acetonide for diffuse diabetic macular edema

Objective To investigate clinical effects of krypton yellow laser combined with triamcinolone acetonide for diffuse diabetic macular edema. Methods Eighty cases with diffuse diabetic macular edema rn accordance with the order of time were divided into the treatment group and the control group ,40 cases in each group , the two groups were applied modified grid laser photocoagulation of krypton yellow laser, and on this basis the treatment group was received triamcinolone acetonide treatment. Results The effective rate were 95. 0% and 85. 0% in the treatment group and the control group , respectively , there was statistical difference ( P < 0. 05 ) . Before treatment , the retinal thickness in the treatment group was ( 632. 25 + 91. 25 ) ym , the control group was (635. 21 + 17. 25) pm, there was no statistical difference (P = 0. 696 ) . After treatment,the retinal thickness in two groups were significantly decreased. the treatment group and contro group were ( 276. 25 + 17. 62 ) ym and ( 312. 52 + 93. 12 ) ym , respectively , there was statistical difference ( P < 0. 05 ) . Before treatment . there was no significant difference in visual acuity between two groups , after I month and 3 months treatment.the visual acuity in two groups were sigruficantly improved , while there was no statistical difference between two groups (P > 0. 05 ) . The leaking disappeared rate in the treatment group and control group were 52. 5% and 37. 5% ,respectively , there was statistical difference ( P < 0. 05 ) . Conclusion Krypton yellow laser combined triamcinolone acetonide for diffuse diabetic macular edema can effectively improve the overall efficacy , and decrease the retinal thickness and fluorescein leakage rate.