Induced Pain Response in Patients with Diabetic Retinopathy during Panretinal Photocoagulation
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目的： 观察并评估糖尿病视网膜病变（DR）患者行全视网膜激光光凝术（PRP）治疗时的疼痛反应。 方法： 回顾性系列病例研究。选择台州市立医院眼科门诊于2019年7─12月进行PRP治疗的DR患者55例，年龄45~72（60.7±7.9）岁，每次PRP治疗后应用数字分级法（NRS）对疼痛反应进行评估。采用Spearman相关分析年龄、性别及各激光部位与疼痛反应程度的相关性。疼痛评分数据采用Fisher精确概率法进行统计分析。 结果： 在纳入的患者中，年龄和性别对患者的疼痛反应均没有影响（r=-0.58，P=0.338；r=0.06，P=0.305）。患者周边部（上、下、鼻、颞）4个象限之间的疼痛反应评分差异无统计学意义（P=0.763）；但后极部光凝疼痛评分低于周边部光凝疼痛评分（P<0.001）。 结论： 在DR患者行PRP术中，后极部的疼痛感轻于周边部，临床医师可优先选择无疼痛或疼痛相对较轻的部位行激光光凝术。 Objective: To observe and evaluate the pain response in patients with diabetic retinopathy (DR) treated with panretinal laser photocoagulation (PRP). Methods: This was a retrospective case series study. Fifty-five patients aged 45-72 years (average age: 60.7¡À7.9 years old) with DR who were treated with PRP from July 2019 to December 2019 were recruited at Taizhou Municipal Hospital. After PRP, the numerical rating scale was used to evaluate the pain response, and the pain responses from peripheral retinal photocoagulation and posterior polar retinal photocoagulation were compared by Spearman correlation analysis. The pain score was statistically analyzed by the Fisher exact test. Results: In this study, age and gender had no effect on the patient's pain response (correlation coefficientr=-0.58, P=0.338 r=0.06, P=0.305). There was no significant difference in pain response between the four quadrants (upper, lower, nasal, temporal) for PRP (P=0.763), but the pain score of the posterior pole was lower than that of peripheral retina (P<0.001). Conclusions: The induced pain response of the posterior pole was milder than that of the peripheral retina in patients with diabetic retinopathy during PRP. The areas with no pain or relatively mild pain from laser photocoagulation should be preferentially considered by doctors.
Objective: To observe and evaluate the pain response in patients with diabetic retinopathy (DR) treated with panretinal laser photocoagulation (PRP). Methods: This was a retrospective case series study. Fifty-five patients aged 45-72 years (average age: 60.7¡À7.9 years old) with DR who were treated with PRP from July 2019 to December 2019 were recruited at Taizhou Municipal Hospital. After PRP, the numerical rating scale was used to evaluate the pain response, and the pain responses from peripheral retinal photocoagulation and posterior polar retinal photocoagulation were compared by Spearman correlation analysis. The pain score was statistically analyzed by the Fisher exact test. Results: In this study, age and gender had no effect on the patient's pain response (correlation coefficientr=-0.58, P=0.338 r=0.06, P=0.305). There was no significant difference in pain response between the four quadrants (upper, lower, nasal, temporal) for PRP (P=0.763), but the pain score of the posterior pole was lower than that of peripheral retina (P<0.001). Conclusions: The induced pain response of the posterior pole was milder than that of the peripheral retina in patients with diabetic retinopathy during PRP. The areas with no pain or relatively mild pain from laser photocoagulation should be preferentially considered by doctors.
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