作者：马雪英，张蓉，李凌 作者单位：810007）中国青海省西宁市，青海省人民医院眼科
【摘要】 目的：观察氩激光视网膜光凝(panretinal photocoagulation,PRP)治疗高原地区糖尿病视网膜病变(diabetic retinopathy,DR)的临床疗效。
【关键词】 糖尿病性视网膜病变；氩激光；视网膜光凝术
Observation on clinical effects of panretinal photocoagulation for diabetic retinopathy of highland area XueYing Ma, Rong Zhang, Ling Li Department of Ophthalmology, the Peoples Hospital of Qinghai Province, Xining 810007, Qinghai Province, China Abstract
AIM: To observe and evaluate the clinical effects of panretinal photocoagulation(PRP) with Argon laser for diabetic retinopathy(DR) of highland area.
METHODS: According to the results of fundus fluorescence angiography (FFA)，panretinal photocoagulation with Argon laser were performed on 257 eyes (176 cases) of DR, including 62 eyes with preproliferative diabetic retinopathy (PPDR), 195 eyes with proliferative diabetic retinopathy (PDR). Examination about FFA, visual acuity and fundus condition were carried out before laser treatment and 3 months after photocoagulation. The regular followup lasted for 6 months to 2 years.
RESULTS: Laser photocoagulation proved effective in 215 eyes (83.7%) with DR, including 57 eyes (91.9%) with PPDR, 158 eyes (81.0%) with PDR. The visual acuity were improved in 59 eyes (23.0%), no changes in 155 eyes (60.3%)，and decreased in 43 eyes(16.7%). Macula lutea edema became heavier was found in 28 eyes（10.9%
CONCLUSION: PRP with Argon laser is a safe and effective method to control the condition of DR. As soon as possible performing PRP may control or delay DR progress, stabilize visual acuity, and may prevent diabetes retina pathological change blinding.
KEYWORDS: diabetic retinopthy; Argon laser; retinal photocoagulation
方法：根据眼底荧光血管造影(fundus fluorescence angiography, FFA)的结果，对176例257眼分别为增殖前期糖尿病性视网膜病变(preproliferative diabetic retinopathy, PPDR)62眼、增殖期糖尿病性视网膜病变(proliferative diabetic retinopathy,PDR)195眼进行氩激光视网膜光凝治疗。治疗前、完成最后一次光凝后3mo分别对患者的视力、眼底、FFA进行检查并追踪观察6mo～2a。
结果：本组257眼经视网膜光凝 治 疗 后215眼有效，总有效率为83.7%。其中PPDR 62眼，有效57眼（91.9%）；PDR 195眼，有效158眼（81.0%），经统计学检验，两者有显著差异(P<0.01)。光凝治疗后视力提高有59眼（23.0%）;155眼视力稳定不变（60.3%）;视力下降43眼（16.7%）。本组病例治疗后有28眼（10.9%）出现黄斑水肿加重，视力下降，经2～3wk后均恢复至光凝治疗前水平
结论：氩激光视网膜光凝术治疗DR是安全、有效的方法，尽早行氩激光视网膜光凝治疗，对于控制或延缓DR的进展，稳定患者视力有重要意义，并可以有效防止DR致盲。
0引言
糖尿病视网膜病变（diabetic retinopathy,DR）是糖尿病的主要并发症，对患者的视力会造成严重的损害，晚期常可导致不可逆性盲，是主要的致盲原因之一。氩激光视网膜光凝(panretinal photocoagulation,PRP)是治疗DR最有效的治疗手段。本组利用氩激光治疗高原地区DR，取得一定疗效，现将研究结果报告如下。
1对象和方法
1.1对象 200601/200809我科治疗DR患者176例257眼，男78例，女98例，年龄36～79（平均57.5）岁。糖尿病史5～23(平均14)a。视网膜光凝前所有患者均行治疗前检查：全身行肝、肾功能，血糖和尿糖，心电图，血压等检查。眼科检查：视力、眼压、视野、眼底镜检查、眼底彩色照像，FFA检查。对眼底有微血管瘤、渗漏、伴有毛细血管无灌注区及新生血管等有Ⅲ期(1985全国DR分期标准[1])以上DR表现的患眼均进行氩激光视网膜光凝治疗。本组病例增殖前期糖尿病性视网膜病变(preproliferative diabetic retinopathy, PPDR)患者62眼，伴眼内视网膜新生血管或纤维血管膜的PDR患者195眼。
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