围手术期血糖控制对糖尿病视网膜病变和黄斑病变进展的影响
Effect of perioperative glycemic control in progression of diabetic retinopathy and ma-culopathy出 版 物：《世界核心医学期刊文摘(眼科学分册)》 (Digest of the World Core Medical Journals)
年 卷 期：2006年第4期
页 面：19-20页
学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学]
主 题：糖尿病视网膜病变 患者 黄斑病变 视网膜疾病 血糖控制 围手术期
摘 要：Objective: To evaluate the contribution of perioperative glycemic control to progression of diabetic retinopathy and maculopathy. Methods: Postoperative progression of diabetic retinopathy and maculopathy were compared in 87 patients with type 2 diabetesmellitus who underwentmonocular phacoemulsification cataract surgery performed by a single surgeon. Twenty-seven patients had had poor glycemic control preoperatively and underwent rapid preoperative glycemic correction;30 patients had poor control preoperatively that was not corrected postoperatively; and 30 patients had good preoperative glycemic control. The grade of diabetic retinopathy and maculopathy in the operated-on eye and the fellow eye was assessed preoperatively and for 12 months postoperatively. Results: There were no significant differences in the progression rate of diabetic retinopathy among the 3 groups (P = .27). However, the progression rate of diabetic maculopathy was significantly higher in the group that underwent rapid control than in the other 2 groups (P = .02). Patients with moderate to severe nonproliferative diabetic retinopathy preoperatively in the rapid control group had significantly higher progression rates of diabetic retinopathy and maculopathy (P = .002 and .008, respectively). Conclusions: Rapid preoperative glycemic control should be avoided in patients with moderate to severe nonproliferative diabetic retinopathy because it may increase the risk of postoperative progression of retinopathy and maculopathy.
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