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目的分析改良全视网膜光凝顺序治疗对重度非增殖期糖尿病性视网膜病变患者黄斑厚度及视力改善的效果。方法选择2015年2月至2016年1月收治的重度非增殖期糖尿病性视网膜病变患者56例,随机分成对照组和研究组,各28例。对照组采用常规全视网膜光凝方法,研究组采用改良全视网膜光凝顺序治疗,观察并比较两组黄斑中心视网膜厚度、最佳矫正视力情况、疗效及并发症发生率。结果分别在治疗后1 d、1周、1个月、3个月、6个月进行随访,研究组在治疗后3、6个月时黄斑中心视网膜厚度低于对照组(P均<0.01),最佳矫正视力优于对照组(P均<0.01)。研究组并发症总发生率低于对照组(3.57%vs 42.86%,P<0.01);治疗总有效率稍高于对照组(96.43%vs 75.00%),但差异无统计学意义(P>0.05)。研究组收缩压、糖化血红蛋白水平低于对照组(P均<0.01)。结论对重度非增殖期糖尿病性视网膜病变患者采用改良全视网膜光凝顺序治疗能有效降低黄斑厚度、提高视力、减少并发症发生率。能否在治疗有效率方面获得有统计学意义的提高,有待进一步扩大样本量探讨。
Objective To analyze the effect of modified panretinal photocoagulation on macular thickness and visual acuity in patients with severe non-proliferative diabetic retinopathy. Methods Fifty-six patients with severe non-proliferative diabetic retinopathy who were admitted from February 2015 to January 2016 were randomly divided into control group and study group, with 28 cases in each group. The control group was treated with conventional panretinal photocoagulation. The study group was treated with modified panretinal photocoagulation. Retinal thickness, best corrected visual acuity, curative effect and complication rate of the two groups were observed and compared. The results were followed up for 1 d, 1 week, 1 month, 3 months and 6 months after treatment. The thickness of the retina in the study group at 3 and 6 months after treatment was lower than that in the control group (all P <0.01) , The best corrected visual acuity was better than the control group (all P <0.01). The overall incidence of complications in the study group was lower than that in the control group (3.57% vs 42.86%, P <0.01). The total effective rate in the study group was slightly higher than that in the control group (96.43% vs 75.00%), but the difference was not statistically significant ). Study group systolic blood pressure, HbA1c levels lower than the control group (P all <0.01). Conclusion The treatment of severe non-proliferative diabetic retinopathy patients with modified panretinal photocoagulation sequence can effectively reduce the thickness of the macular, improve visual acuity and reduce the incidence of complications. There is a statistically significant improvement in treatment effectiveness, pending further exploration of the sample size.