半全视网膜激光光凝术治疗阈值前和阈值期早产儿视网膜病变的疗效
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深圳市卫生计生系统科研项目(No.SZFZ2018028)


Clinical effect of semi-panretinal laser photocoagulation in prethreshold and threshold retinopathy of premature infants
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Scientific Research Program in Health Family Planning System of Shenzhen(No.SZFZ2018028)

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    摘要:

    目的:观察半全视网膜激光光凝治疗阈值前和阈值期早产儿视网膜病变(ROP)的临床疗效和安全性。

    方法:经临床确诊的ROP患儿25例46眼纳入研究。其中,阈值前病变24眼,阈值病变22眼。46眼中,Ⅰ区病变20眼,Ⅱ区病变26眼。所有患儿均在全身麻醉下采用波长为810nm 的Iridis激光机经双目间接检眼镜输出,保留Ⅰ区及其颞侧2个视乳头直径区域不接受光凝,对其余无血管区进行光凝治疗。随访42~881(362±59.6)d,进行疗效分析。

    结果:一次光凝术后病变完全消退38眼(83%); 进展期患眼8眼(17%)经Ⅰ区颞侧2PD区域补全激光光凝治疗,二次光凝治疗时间在首次治疗术后33~45d,病变完全消退。未出现局部纤维增生、局限性视网膜脱离等严重并发症。阈值前病变组24眼中,病变完全消退22眼(92%); 阈值病变组22眼中,病变完全消退10眼(73%)。两组病变完全消退率比较,差异有统计学意义(P<0.05)。

    结论:半全视网膜激光光凝术可以有效治疗阈值前和阈值期早产儿视网膜病变,对周边视网膜破坏少。

    Abstract:

    AIM: To explore the clinical curative effect of semi-panretinal laser photocoagulation in treatment of the prethreshold and threshold retinopathy of premature(ROP)infants.

    METHODS:Totally 25 patients with ROP were selected, 24 eyes of prethreshold, 22 eyes of threshold period. All preterm infants(46 eyes)were given semi-panretinal laser photocoagulation vialaser indirect ophthalmoscopy and completed the 42-881(362±59.6)d follow-up period.

    RESULTS: ROP regressed after single photocoagulation in 38 eyes(83%)and in 8 eyes(17%)after the second photocoagulation totally. No infants had localized proliferation or detachment post total treatment. The regression of retinopathy was found in 22 eyes in prethreshold group(92%)and in 16 eyes in threshold group(73%), while the difference was statistically significant(P<0.05).

    CONCLUSION: The effects of semi-panretinal laser photocoagulation in treatment of the prethreshold and threshold ROP are quite. The benefits of protected larger vision field have the potential to improve ROP outcomes.

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曹贺,张璐.半全视网膜激光光凝术治疗阈值前和阈值期早产儿视网膜病变的疗效.国际眼科杂志, 2019,19(8):1411-1414.

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  • 收稿日期:2019-04-23
  • 最后修改日期:2019-07-03
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  • 在线发布日期: 2019-07-25
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