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題名 | Retinal Outcomes in Proliferative Diabetic Retinopathy Presenting during and after Pregnancy=在懷孕中及生產後發生增生性糖尿病網膜病變之預後 |
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作者姓名(中文) | 陳勇仁; 郭錫恭; 黃宣為; | 書刊名 | 長庚醫學 |
卷期 | 27:9 民93.09 |
頁次 | 頁678-684 |
分類號 | 417.346 |
關鍵詞 | 懷孕; 增生性糖尿病網膜病變; 增生性網膜病變; 糖尿病網膜病變; Pregnancy; Diabetic retinopathy; Proliferative retinopathy; Proliferative diabetic retinopathy; |
語文 | 英文(English) |
中文摘要 | 背景:研究在懷孕中及生產後1年內,發生增生性糖尿病網膜病變婦女的網膜預後。 方法:自1992年至2002年,回顧分析所有診斷為糖尿病且懷孕的病例。記錄其產科的病史、生產的結果、內科的併發症、網膜疾病的病程與處理。 結果:總共6位女性(8.2%)於7次懷孕當中,在懷孕中及生產後1年內發生增生性糖尿病網膜病變。其中2位在共3次的懷孕中,因先前的增生性糖尿病網膜病變已經接受全網膜雷射凝固術治療,這2位女性的網膜,在懷孕中及生產後都很穩定。3位女性(其中4眼)在懷孕中表現出高危險性之增生性糖尿病網膜病,其中3隻眼在產後1年內,需再接受雷射凝固術治療或玻璃體切除手術(其中1眼)。2位女性(其中3眼)在生產後表現出非增生性糖尿病網膜病變,但是於產後1年內惡化至增生性糖尿病網膜病。於生產2年後,共9隻眼仍保持穩定的網膜,2隻眼演變至萎縮,1隻眼演變至末期增生性糖尿病網膜病變。 結論:因為生產會導致糖尿病網膜病變的惡化,小心的網膜監視及適當的治療,不僅在懷孕中,而且在生產後都很重要。 |
英文摘要 | Background: The aim of this study was to determine retinal outcomes in patients with proliferative diabetic retinopathy (PDR) presenting during pregnancy or within the first year postpartum. Methods: All patients with diabetes mellitus during pregnancy from 1992 through 2002 were included. Medical records were reviewed and data including obstetric history, pregnancy outcome, other medical complications, and course and management of retinal disease were analyzed. Results: The study group comprised 6 women with a total of 7 pregnancies complicated by PDR during pregnancy or during the first year postpartum. Two of these pregnancies were in patients who had long-standing PDR and had received panretinal photocoagulation prior to pregnancy. Both of them had stable retinas during pregnancy and during the postpartum period. Three patients (4 eyes) who presented with high risk PDR during pregnancy required either repeated laser therapy (3 eyes) or vitrectomy (one eye) during the first year postpartum. Two patients (3 eyes) who did not have PDR at delivery developed PDR during the first year postpartum. After the second year postpartum, nine eyes which had developed PDR during or post pregnancy had stable retinas, two had developed phthisis, and one manifested end stage PDR. Conclusions: Because of the persistent adverse effects of pregnancy on the retinas of women with diabetes mellitus, meticulous retinal surveillance and appropriate therapy are important not only during pregnancy but also during the postnatal period. |
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