體外反搏聯合全視網膜激光光凝治療非增生型糖尿病視網膜病變

利煥廉，周金文，左　煒

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體外反搏聯合全視網膜激光光凝治療非增生型糖尿病視網膜病變

利煥廉，周金文，左煒

?METHODS: A prospective study method were used from Aug.2013 to Feb.2016. A total of 104 cases in our hospital for treatment of non-proliferative stage of diabetic retinopathy patients were selected as the research object, and all the patients were equally divided into observation group and control group, 52 cases in each group according to the order of admission. Patients in control group were treated with panretinal laser photocoagulation treatment. The observation group were given external counterpulsation combined with laser photocoagulation for treatment, observed the prognosis in the two groups.

?RESULTS: The total efficiency in the observation group and the control group were 98.1% and 84.6%, the observation group was significantly higher than the control group (P<0.05). The eye artery EDV and PSV values in the observation group and the control group after treatment were significantly higher than those before treatment (P<0.05), while the observation group after treatment of eye artery EDV and PSV value were significantly higher than those in control group (P<0.05). The CMT values in the observation group before and after treatment were 198.13±45.32μm and 200.46±31.94μm, while the control group were 203.14±51.94μm and 202.90±42.95μm that compared between the two groups were not statistically significant (P>0.05).

?CONCLUSION: External counterpulsation combined with laser photocoagulation treatment has good safety in the treatment of non-proliferative diabetic retinopathy, it can promote eye artery blood flow speed, thereby improve the therapeutic effect.

目的：探討體外反搏聯合全視網膜激光光凝治療非增生型糖尿病視網膜病變的療效。

方法：采用前瞻性研究方法，選擇2013-08/2016-02在我院診治的非增生期糖尿病視網膜病變患者104例104眼作為研究對象，根據入院順序分為觀察組與對照組各52例52眼，對照組采用全視網膜激光光凝治療，觀察組在對照組治療的基礎上給予體外反搏治療，觀察兩組預后情況。

結果：觀察組與對照組的總有效率分別為98.1%、84.6%，觀察組明顯高于對照組，差異有統計學意義(P<0.05)。觀察組與對照組治療后的患眼動脈EDV與PSV值都明顯高于治療前，差異有統計學意義(P<0.05)，同時觀察組治療后的患眼動脈EDV與PSV值也明顯高于對照組，差異有統計學意義(P<0.05)。觀察組治療前后的CMT值分別為198.13±45.32、200.46±31.94μm，而對照組分別為203.14±51.94、202.90±42.95μm，在組內與組間對比都無統計學意義(P>0.05)。

結論：體外反搏聯合全視網膜激光光凝治療非增生型糖尿病視網膜病變具有很好的安全性，能促使眼動脈血流速度加快，從而提高治療療效。

體外反搏；全視網膜激光光凝；非增生型糖尿病視網膜病變；血流速度

引用：利煥廉，周金文，左煒.體外反搏聯合全視網膜激光光凝治療非增生型糖尿病視網膜病變.國際眼科雜志2016;16(11):2082-2084

0　引言

糖尿病視網膜病變(diabetic retinopathy, DR)是糖尿病眼部的主要并發癥，也已經成為成年人低視力和盲的主要原因之一。非增生期糖尿病視網膜病變為糖尿病視網膜病變的主要類型，早期眼底改變以微血管瘤、滲出、出血等為主，后期可出現玻璃體積血、牽拉性視網膜脫離等[1-2]。其發病機制與很多因素有關，包括神經元軸漿流的轉運受損、神經缺乏營養供給、血糖水平高導致的代謝紊亂等[3-4]。激光光凝是治療非增生期糖尿病視網膜病變的有效手段，可有效減少缺血缺氧誘導的新生血管生成因子合成和釋放，緩解內層視網膜缺氧，延緩疾病的發展，但是持續效果一直不太好，對于視功能的改善作用不佳[5-6]?！?br>