4-2-1原则指导下的糖尿病性视网膜病变激光疗效观察.pdfVIP

中国实用眼科杂志2015 年6月第33 卷第6期 Chin J Pract Ophthalmol , June 2015 , Vol33 , No.6 .591. ·论著:临床研究· 4-2-1 原则指导下的糖尿病性视网膜病变 激光疗效观察 徐鼎李春霞贾万程张忆肖文均张淑萍陆士恒刘晴雨王方 [摘要] 目的观察4-2-1 原则指导的重度非增殖性糖尿病性视网膜病变 (NPDR) 全视网膜光凝 (PRP) 的疗效。方法多中心前瞻性非对照临床研究。对2010 年4 月至2012 年4 月在同济大学附属第 十人民医院等4家医院眼科根据4-2-1 原则确诊的重度NPDR患者的例 (43 只眼)行PRP治疗。随访6 个月。 PRP前后行最佳矫正视力 (BCVA) 、眼底彩色照相、眼底荧光血管造影 (FFA) 等检查。 6 个月 的随ìjj观察指标进行疗效评价。结果 PRP前后平均BCVA分别为 (59.91:t 14.58) 和 (62.86:t 15.4 1)个 字母，差异无统计学意义 (t =1.782 , P 0.05) 。视力有效为39 只眼 (90.7%) 。眼底检查显示38 只 眼 (88.377毛)有效; FFA 显示36 只眼 (83.72%) 有效，两者相比差异无统计学意义 (x=0.19 ， P 0.05) 。结论在没有条件进行FFA检查的情况下，根据4-2一1 原则进行DR 光凝是一个行之有效的方 法，绝大多数重度NPDR患者可以有效地控制病变发展，防止视力严重受损。 [关键词] 糖尿病性视网膜病变;激光凝固术; 4-2-1 原则 Therapeutic efficacy of laser photocoagulation for diabetic retinopathy by 4-2-1 rule Xu Ding, Li Chunxia, Jia Wancheng, Zhang Yi, Xiao Wenwei, Zhang Shuping, Lu Shiheng, Liu Qing川， Wang Fang.Department of Ophthalmology, Shanghai Tenth People s Hospital, Tongji University School of Medicine, Shanghai 200072, China; Department of Ophthalmology, Shanghai TCM-integrated Hospital , Shanghai 200082, China; Department of Ophthalmology, Shanghai Fengxian District Central Hospital, Shanghai 201499, China; Department of Ophthalmology, Shanghai PudongGongli Hospital, Shanghai 200135, China Corresponding author: \.\旬ng Fang, Email:163.com [Abstract] Objective To observe the efficacy of laser therapy for severe non-proli缸ativediabet­ ic retinopathy (NPDR) by 4-2-1 rule. Methods A multi-center,prospective and non-controlled clinical study. Forty-three patients (43eyes) who were diagnosed as severe NPDR by 4-2-1 rule were includ- ed. All eyes were received pan-retinal photocoagulation (PRP) and followed up 6 months. Best cor- rected visual acuity (BCVA) , fundus p