在墨西哥城使用视网膜造影在一级护理中筛查糖尿病视网膜病变

Daniel Paniagua Herrera, Consuelo González Salinas
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摘要

目的:根据2型糖尿病患者的发展时间、视力丧失程度及是否进行屈光矫正,通过视网膜造影了解糖尿病视网膜病变及糖尿病黄斑水肿的患病率。方法:对150例2型糖尿病患者进行描述性横断面研究,这些患者来自墨西哥城卫生服务局Tlalpan卫生管辖区的各个卫生中心,验光评估。结果:150例60岁患者(女性70%,男性30%)诊断为2型糖尿病,其中52%的患者病程为12.09年(+/ - 3.48)。72.33%的患者有视网膜病变和/或糖尿病性黄斑水肿病变。屈光矫正后的平均视力由0.62(+/ - 0.48)提高到0.37(+/ - 0.38),绝对残疾下降- 18.76%,无残疾或轻度残疾增加31.31%。在总人口中,75.5%的人仍在接受初级保健监测,24.5%的人转诊到眼科三级保健。结论:与视网膜病变和糖尿病性黄斑水肿引起的视力丧失作斗争的战略机遇在于,在初级保健水平接受过检查和控制培训的卫生人员能够及时发现这一问题,这将减少三级保健的医院负荷,从而降低卫生系统的成本,并提高获得视力的年数和患者整体视力优化的成本效益。
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Cribado de la retinopatía diabética en el primer nivel de atención usando retinografía en la Ciudad de México
Objective:To determine the prevalence of diabetic retinopathy and diabetic macular edema by means of retinography in patients diagnosed with Type 2 diabetes mellitus according to time of evolution and degree of vision loss with and without refractive correction.Method: A descriptive cross-sectional study of 150 patients with Type 2 diabetes mellitus assessed in optometry in various health centers from the Sanitary Jurisdiction of Tlalpan, Health Services of Mexico City.Results: 150 patients (70% women, 30% men) aged 60 (+/– 7.77) were diagnosed with Type 2 diabetes mellitus, 52% of them with an evolution of 12.09 years (+/– 3.48). Of the total number of patients, 72.33% had retinopathy and/or diabetic macular edema lesions. The average visual acuity improved from 0.62 (+/– 0.48) to 0.37 (+/– 0.38) with refractive correction, absolute disability decreased by –18.76% and null or slight disability increased by 31.31%. Of the total population, 75.5% remained under monitoring in primary care, and 24.5% were referred to tertiary care in ophthalmology.Conclusion: The strategic opportunity to combat vision loss due to retinopathy and diabetic macular edema is found in its timely detection by health personnel trained in scrutiny and control at the primary care level, which would represent a decreased hospital load in tertiary care, thereby reducing costs for the health systems, as well as cost-efficiency for the years of sight gained and optimization of the patient’s global vision.
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