多点扫描一次完成PRP治疗NPDR患者的临床效果分析

目的:探讨多点扫描一次完成全视网膜激光光凝(PRP)治疗非增生期糖尿病视网膜病变(NPDR)的临床效果.方法:选取2015-01/2016-06在我院治疗的NPDR患者78例132眼,将患者随机分为观察组(42例72眼)和对照组(36例60眼),观察组给予多点扫描,一次完成PRP,对照组给予单点扫描,分3~4次完成PRP.观察两组治疗效果、视野平均阈值、闪光视网膜电流图(F-ERG)a、b波振幅、激光能量等.结果:观察组和对照组治疗有效率分别为84.7%和83.3%,差异无统计学意义(P>0.05);观察组和对照组治疗后6mo视网膜新生血管荧光素渗漏面积均较治疗前降低,差异有统计学意义(P<0.05);两组治疗前和治疗后6mo视野平均阈值、F-ERG a波振幅比较差异无统计学意义(P>0.05);观察组和对照组治疗后6mo F-ERG b波振幅分别为221.94±70.18和219.82±69.56mV,较治疗前明显降低,差异有统计学意义(P<0.05);观察组激光能量为541.23±56.39mW,明显高于对照组(326.39±78.83mW),差异有统计学意义(P<0.05),而能量密度为0.34±0.14mW·ms/mm2,明显少于对照组(2.01±0.97mW·ms/mm2),差异有统计学意义(P<0.05);观察组和对照组并发症发生率分别为8.3%和15.0%,差异有统计学意义(P<0.05).结论:多点扫描一次完成PRP治疗NPDR的疗效较好,相比较单点多次PRP,具有能量密度低,产生的激光损伤小的优点.

Effect of one-dose multiple point scanning PRP treatment on patients with NPDR

AIM: To investigate the clinical effect of one-dose multiple point scanning panretinal photocoagulation(PRP)in the treatment of non-proliferative diabetic retinopathy(NPDR).

METHODS:Selected 78 patients 132 eyes with NPDR in our hospital from January 2015 to June 2016, the patients were randomly divided into observation group(42 patients of 72 eyes)and control group(36 patients of 60 eyes). The observation group was given one-dose multi-point scanning PRP. The control group was given a single point scanning, 3 to 4 times to complete the PRP. To observethe therapeutic effect in two groups, the average visual field threshold, the flash electroretinogram(F-ERG)a, b wave amplitude, the laser energy and so on were observed.

RESULTS:The effective rate of the observation group and the control group were 84.7% and 83.3%, the difference was not statistically significant(P>0.05). In the observation group and the control group, at 6mo after treatment, the leakage area of retinal neovascularization was lower than that before treatment(P<0.05). The visual field threshold and F-ERG a wave amplitude differences were not statistically significant(P>0.05). F-ERG b wave amplitude were 221.94±70.18mV and 219.82±69.56mV in the observation group and the control group at 6mo after treatment which were significantly lower than that before treatment(P<0.05). The laser energy of the observation group was 541.23 ± 56.39mW, significantly higher than the control group 326.39±78.83mW(P<0.05), while the energy density was 0.34±0.14mW·ms/mm², significantly less than the control group 2.01±0.97mW·ms/mm²(P<0.05). The incidence of complications in the observation group and the control group were 8.3% and 15.0%, the difference was statistically significant(P<0.05).

CONCLUSION:The clinical effect of multiple point scanning PRP in the treatment of NPDR is better than single point multiple PRP with advantages of lower energy density and less laser damage.