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1、湖南师范大学学报(医学版)2007,4(2)16JHunanNormalUniv(MedSci)Ξ糖尿病视网膜病变激光治疗后玻璃体出血的临床分析丰昀,朱小华,郭小健,田(中南大学湘雅二医院眼科,湖南长沙410011)[摘要]目的:探讨糖尿病视网膜病变(diabeticretinopathy,DR)激光光凝术后玻璃体出血的发生率、临床特点及疗效。方法:本研究对199622005年598例949眼DR患者行激光光凝术。术后追踪随访6238个月,平均18个月。结果:Ⅰ型糖尿病患者在激光光凝术后玻璃体出
2、血的发生率为28.77%,Ⅱ型糖尿病患者的发生率为8.22%。Ⅰ型糖尿病患者激光光凝术后发生玻璃体出血的几率明显高于Ⅱ型糖尿病患者(P<0.01)。Ⅲ期DR患者在激光光凝术后玻璃体出血的发生率为6.83%,Ⅳ期DR患者的发生率为14.29%。Ⅲ期DR患者激光光凝术后发生玻璃体出血的几率显著低于Ⅳ期患者(P<0.01)。75.27%的玻璃体出血患者经过保守治疗和补充激光光凝后,玻璃体出血吸收,24.73%的患者需行玻璃体视网膜手术。结论:DR达Ⅲ期以上者激光光凝术后仍可发生玻璃体出血,并发玻璃体出
3、血的患者经过积极治疗,可获得较好的疗效。[关键词]糖尿病视网膜病变;激光光凝;玻璃体出血[中图分类号]R774.1[文献标识码]A[文章编号]16732016x(2007)0220016204TheClinicAnalysisofVitreousHemorrhageafterLaserPhotocoagulationforDiabeticRetinopathyFENGYun,ZHUXiao2hua,GUOXiao2jian,TIANYu.(DepartmentofOphthalmology,th
4、esecondXiangyaHospital,CentralSouthUniversity,Changsha410011,China)[Abstract]ObjectiveToinvestigatetheincidencerateandthecliniccharacteristicofvitreoushemorrhageafterla2serphotocoagulationfordiabeticretinopathy(DR).Methods949eyesof598DRpatientshadund
5、ergonelaserphotocoagu2lationinourresearchfrom1996to2005.Medianfollow2upwas18months(rangeof6238months).ResultsTheincidencerateofvitreoushemorrhageafterlaserphotocoagulationwas28.77%inthetype1diabeticpatients,and8.22%inthetype2diabeticpatients.Theincid
6、encerateofvitreoushemorrhageafterlaserphotocoagulationinthetype1diabeticpatientswassignificantlyhigherthanthatinthetype2diabeticpatients(P<0.01).Theincidencerateofvitreoushemorrhageafterla2serphotocoagulationwas6.28%inpatientswithDRstageⅢ,and14.29%in
7、patientswithDRstageⅣ.TheincidencerateofvitreoushemorrhageafterlaserphotocoagulationinpatientswithDRstageⅢwaslowerthanthatinpatientswithDRstageⅣ(P<0.01).Thevitreoushemorrhagewasabsorbedaftermedicinetherapyandaddedlaserphotocoagulationin75.27%,andvitre
8、oretinalsurgerywasrequiredin24.73%.ConclusionsThevitreoushemorrhageoccurredinpatientswithDRstageⅢupwardsafterlaserphotocoagulationsometimes.Thesepatientswithvitreoushemorrhagemayattainabetteroutcomeafteractivetherapy.[Keywords]diabeticretinopathy;las
