基层医院激光治疗糖尿病视网膜病变临床观察

目的：探讨基层医院全视网膜光凝治疗糖尿病视网膜病变的疗效。

方法：对55例92眼分别为增殖前期糖尿病视网膜病变(PPDR)、增殖期糖尿病视网膜病变(PDR)患者进行全视网膜光凝术，术后3， 6， 12mo行眼底荧光血管造影(FFA)及彩色眼底像， 新生血管未消退者和无灌注区尚存者追加光凝， 随访3～12mo。

结果：全视网膜光凝术后PPDR视力提高和视力不变者23眼(77%)，视力下降者7眼(23%)； PDR视力提高和视力不变者44眼(71%)，视力下降者18眼(29%)。经过一次全视网膜光凝后，3mo复查FFA，新生血管未退、无灌注区未消失者追加光凝，PPDR有效率为29 眼(97%)，PDR有效率为50 眼(81%)； 13眼(14%)出现玻璃体出血转上级医院行玻璃体切割术。

结论：基层医院全视网膜光凝治疗糖尿病视网膜病变疗效良好。

Clinical observation on treatment of diabetic retinopathy with laser photocoagulation in the primary hospital

AIM: To observe the effects of panretinal photocoagulation for diabetic retinopathy in the primary hospital.

METHODS: A total of 92 eyes in 55 cases respectively suffering from preproliferative diabetic retinopathy(PPDR), proliferative diabetic retinopathy(PDR)were treated with panretinal photocoagulation. The fundus fluorescein angiography(FFA)and color photograph were taken 3, 6, 12mo after the treatment. For those cases with remaining new vessels and non-perfusion areas, the treatment was complemented with further photocoagulation. The follow-up period was 3-12mo.

RESULTS: After treating with panretinal photocoagulation, visual acuity were improved or maintained in 23 eyes(77%)and decreased in 7 eyes(23%)in group of PPDR; Visual acuity were improved or maintained in 44 eyes(71%)and decreased in 18 eyes(29%)in group of PDR. After one time panretinal photocoagulation, for those cases with remaining new vessels and non-perfusion areas, the treatment was complemented with further photocoagulation in 3mo after FFA, the effective rate was 29 eyes(97%)in group of PPDR, 50 eyes(81%)in group of PDR; 13 eyes(14%)developed vitreous hemorrhage, were turned to the superior hospital for vitrectomy.

CONCLUSION:Panretinal photocoagulation is obviously effective in the treatment of diabetic retinopathy in the primary hospital.