本文選題：全視網(wǎng)膜激光光凝術(shù) + 糖尿病性視網(wǎng)膜疾病��； 參考：《吉林大學(xué)》2012年碩士論文

【摘要】：目的：評價(jià)糖尿病性視網(wǎng)膜病變（VI期）（proliferative diabeticretinopathy，PDR）玻璃體切割術(shù)中光凝量對術(shù)后療效的影響分析；術(shù)中適當(dāng)?shù)墓饽颗c術(shù)后療效存在一定積極的聯(lián)系。 方法：分析2010年1月至2011年6月，選取56例吉林大學(xué)第二醫(yī)院糖尿病性視網(wǎng)膜病變（VI期）患者玻璃體切割術(shù)58只眼，除外術(shù)前行激光光凝術(shù)，，在性別、眼別、年齡、病程、血糖控制水平上均無統(tǒng)計(jì)學(xué)差異。按照統(tǒng)計(jì)的術(shù)中有效激光點(diǎn)數(shù)分組，以800點(diǎn)以下、800~1500點(diǎn)、1500點(diǎn)以上分為A、B、C三組。隨訪半年，探討術(shù)中激光量對術(shù)后療效的影響分析，分別從短期和長期的視力、眼壓、眼內(nèi)再出血、視網(wǎng)膜新生血管是否消退等方面研究。 結(jié)果：（1）研究組中47眼（81.03%）術(shù)后視力提高，其中A組14眼（73.68%），B組19眼（86.36%），C組14眼（82.35%），三組間術(shù)后視力提高無統(tǒng)計(jì)學(xué)差異（P=0.642）。（2）本研究組中術(shù)后（一周內(nèi)）高眼壓共30眼（51.72%），其中A組9眼（47.37%），B組13眼（59.10%），C組8眼（47.06%），A組、B組和C組間術(shù)后（一周內(nèi)）眼壓不存在統(tǒng)計(jì)學(xué)差異（P=0.677）；術(shù)后隨訪一個(gè)月以上，高眼壓共8眼（13.79%），其中A組6眼（31.58%），B組1眼（4.55%），C組1眼（5.88%），三組比較，激光量不同與眼壓存在統(tǒng)計(jì)學(xué)差異（P=0.043）。（3）術(shù)后（一周內(nèi)）眼內(nèi)再出血共13眼（22.41%），其中A組5眼（23.32%），B組4眼（18.18%），C組4眼（23.53%），三組間比較，不存在統(tǒng)計(jì)學(xué)差異（P=0.857）；術(shù)后3周以上，共6眼（10.34%）發(fā)生眼內(nèi)再出血，其中A組5眼（26.31%），B組1眼（4.55%），C組未發(fā)現(xiàn)眼內(nèi)再出血，三組比較存在統(tǒng)計(jì)學(xué)差異（P=0.020）。（4）所研究組58眼中一次性視網(wǎng)膜解剖復(fù)位成功55眼(94.83%)，A組17眼（97.62%），B組21眼（95.45%），C組17眼（100%）。 結(jié)論：（1）PRP術(shù)能有效地降低增殖性糖尿病性視網(wǎng)膜病變者致盲的風(fēng)險(xiǎn)。（2）適當(dāng)?shù)墓饽拷档土瞬Ａw切割術(shù)后眼內(nèi)再出血的發(fā)生率，并且能有效的控制眼壓平穩(wěn)，使眼底供血的最優(yōu)化分配，延緩了疾病的惡化。（3）激光量不足增加了眼底再出血和眼壓控制不良的風(fēng)險(xiǎn)。(4)PRP術(shù)與術(shù)后視力提高無明顯聯(lián)系。
[Abstract]:Objective: to evaluate the effect of photocoagulation during vitrectomy on postoperative efficacy in patients with diabetic retinopathy (PDR), and there was a positive correlation between the appropriate amount of photocoagulation and the postoperative effect. Methods: from January 2010 to June 2011, 58 eyes of 56 patients with diabetic retinopathy (stage VI) in the second Hospital of Jilin University were treated with laser photocoagulation before operation except for sex, eye type, age, course of disease. There was no statistical difference in blood glucose control level. According to the number of effective laser points in operation, three groups were divided into three groups: the number of points below 800 points was more than 1500 points and the number of points was more than 1500 points. To investigate the effect of intraoperative laser volume on postoperative curative effect, the short-term and long-term visual acuity, intraocular pressure, intraocular rebleeding and retinal neovascularization were studied. Results in the study group, 47 eyes (81.03 eyes) had improved visual acuity after operation. There were 14 eyes in group A, 73.68 eyes in group B, 19 eyes in group B, 19 eyes in group C, 14 eyes in group C, 14 eyes in group C, and 14 eyes in group C, there was no significant difference in postoperative visual acuity among the three groups. There was no significant difference in postoperative visual acuity between the three groups. In this study group, there were 30 eyes with high IOP (within one week) after operation (within one week). Among them, 9 eyes in group A, 9 eyes in group B, 13 eyes in group C, 59.10 eyes in group C, 8 eyes in group A, group A, and group C, group A, group A, group A, group A, group A, group A, group B and group C, group B and group C, 8 eyes. There was no significant difference in intraocular pressure between the two groups (within one week), and the postoperative follow-up was more than one month. The IOP was 13.79 in 8 eyes, of which 6 eyes in group A (31.58 eyes) and 1 eye in group B (4.55 eyes) and 1 eye in group C (5.88%) were compared. There were statistical differences between laser volume and intraocular pressure (P < 0.043) and intraocular hemorrhage in 13 eyes (within one week). Among them, 5 eyes in group A had intraocular hemorrhage, 5 eyes in group A and 4 eyes in group B, 4 eyes in group B and 18.18% in group C, there was no statistical difference between the three groups (P > 0.857), and there was no statistical difference between the three groups (P > 3 weeks after operation). Intraocular rebleeding occurred in 6 eyes (10.34%), and no intraocular rebleeding was found in group A (5 eyes), group B (1 eye) and group B (1 eye). There were statistical differences among the three groups (P < 0.020). In the study group, 55 eyes (94.83 eyes) of 58 eyes in the study group were successfully reattached once, and 17 eyes (97.62%) in group A had 17 eyes (97.62%) and 21 eyes (21 eyes) in group B were compared with 17 eyes in group C (17 eyes). Conclusion ProprP can effectively reduce the risk of blindness in patients with proliferative diabetic retinopathy. Proper photocoagulation can reduce the incidence of intraocular rebleeding after vitrectomy, and can effectively control intraocular pressure. The optimal distribution of blood supply to the fundus delayed the deterioration of the disease. The insufficient amount of laser increased the risk of rebleeding in the fundus and the risk of poor intraocular pressure control. There was no significant correlation between PRP and postoperative visual acuity.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R779.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前8條

1 彭華琮;袁媛;;眼科激光對角膜內(nèi)皮的影響[J];臨床眼科雜志;2009年05期

2 王中穎;孫曉雷;張桂榮;;107例眼底熒光血管造影觀察糖尿病性視網(wǎng)膜病變毛細(xì)血管無灌注區(qū)的分布特點(diǎn)[J];內(nèi)蒙古醫(yī)學(xué)雜志;2005年12期

3 李暉;宋蓓文;杜新華;吳強(qiáng);;增殖性糖尿病性視網(wǎng)膜病變玻璃體切割術(shù)后高眼壓分析[J];上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2008年06期

4 孫心銓;眼科激光和眼底病激光的分類、選擇[J];眼科;1997年02期

5 孫心銓,王燕琪,李愛紅;糖尿病視網(wǎng)膜病變?nèi)暰W(wǎng)膜光凝術(shù)后中長期隨診結(jié)果[J];眼科;2003年03期

6 崔彥;許迅;;糖尿病性視網(wǎng)膜病變分子機(jī)制的研究進(jìn)展[J];眼視光學(xué)雜志;2007年02期

7 杜磊;邢怡橋;陳長征;;曲安奈德輔助顯示玻璃體切割術(shù)中殘留的玻璃體后皮質(zhì)[J];中國實(shí)用眼科雜志;2006年07期

8 劉紅,谷萬章,穆秀云;慢性腎小球腎炎繼發(fā)雙眼視網(wǎng)膜、脈絡(luò)膜脫離[J];中國實(shí)用眼科雜志;1999年12期

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