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目的:探讨基层医院糖尿病视网膜病变(DR)早期发现、早期诊治、长期随访。方法:观察住院、会诊患者、眼科门诊就诊患者1 330例,已经临床确诊的153例(306眼)2型糖尿病患者。眼科检查包括视力检查,眼前节裂隙灯显微镜检查,眼压检查,以及散瞳直、间接检眼镜眼底或三面镜检查。根据检查情况确诊有无DR,并进行分期。随访1-2年。发现DR患者后均建议其到上级医院行眼底荧光血管造影(FFA),DR3-4期患者建议行视网膜光凝治疗,DR 5-6期患者建议行玻璃体切割加视网膜光凝治疗。结果:确诊为糖尿病患者306眼,患病率为11.5%,其中发生DR74眼,占糖尿病患者的24.18%。单纯型视网膜病变63眼,占糖尿病患者的20.59%,增殖性视网膜病变患者11眼,占糖尿病视网膜病变患者的3.59%。病程越长其DR发病率越高,年龄越大发病率越高,眼底改变也越严重,空腹血糖>6.8 mmol/L比空腹血糖≤6.8 mmol/L DR发生率明显增加。结论:糖尿病视网膜病变(DR)是糖尿病严重并发症之一,也是目前主要致盲原因之一,应该早期发现、早期诊治、长期随访,预防糖尿病视网膜病变致盲的发生。
Objective: To explore the early detection, early diagnosis and treatment of diabetic retinopathy (DR) in primary hospitals and long-term follow-up. Methods: A total of 1 330 inpatients, consultation patients and ophthalmology clinic patients and 153 patients (306 eyes) with clinically confirmed type 2 diabetes mellitus were observed. Eye examinations include visual acuity, anterior segment slit lamp microscopy, intraocular pressure examination, and mydriasis straight, indirect ophthalmoscope fundus or three-mirror examination. According to check the situation diagnosed with or without DR, and staging. Follow-up 1-2 years. Found that DR patients were recommended to the higher hospital fundus fluorescein angiography (FFA), DR3-4 patients recommended retinal photocoagulation treatment, DR 5-6 patients recommended vitrectomy and retinal photocoagulation. Results: There were 306 eyes diagnosed as diabetic patients with a prevalence of 11.5%, of which DR74 eyes occurred, accounting for 24.18% of those with diabetes. 63 cases of simple retinopathy, accounting for 20.59% of diabetic patients, proliferative retinopathy in 11 eyes, accounting for 3.59% of patients with diabetic retinopathy. The longer the duration of the higher the incidence of DR, the higher the incidence of older, fundus changes more serious, fasting blood glucose> 6.8 mmol / L than fasting blood glucose ≤ 6.8 mmol / L DR incidence increased significantly. Conclusion: Diabetic retinopathy (DR) is one of the serious complications of diabetes mellitus, which is one of the main causes of blindness. Early detection, early diagnosis and treatment and long-term follow-up should be done to prevent the blindness of diabetic retinopathy.