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目的:探讨糖尿病视网膜病变(diabetic retinopathy,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1996-2005年598例949眼DR患者行激光光凝术。术后追踪随访6-38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,并发玻璃体出血的患者经过积极治疗,可获得较好的疗效。
Objective: To investigate the incidence, clinical characteristics and curative effect of vitreous hemorrhage after laser photocoagulation in diabetic retinopathy (DR). Methods: In this study, we performed laser photocoagulation on 598 patients with DR of 949 from 1996 to 2005. Postoperative follow-up 6-38 months, an average of 18 months. Results: The incidence of vitreous hemorrhage in patients with type 1 diabetes mellitus after laser photocoagulation was 28.77%, and the incidence of type 2 diabetes mellitus was 8.22%. The incidence of vitreous hemorrhage after laser photocoagulation in type 1 diabetic patients was significantly higher than that in type 2 diabetic patients (P <0.01). The incidence of vitreous hemorrhage in patients with stage Ⅲ DR after laser photocoagulation was 6.83%. The incidence of stage Ⅳ DR patients was 14.29%. The incidence of vitreous hemorrhage after laser photocoagulation in stage III patients was significantly lower than that in stage IV patients (P <0.01). 75.27% of patients with vitreous hemorrhage after conservative treatment and laser photocoagulation, vitreous hemorrhage absorption, 24.73% of patients underwent vitreoretinal surgery. Conclusion: Patients with stage Ⅲ or more DR after laser photocoagulation may still have vitreous hemorrhage. After active treatment, patients with vitreous hemorrhage may obtain better curative effect.