摘要
目的评价几种治疗方案对非动脉炎性前部缺血性视神经病变(NAION)水肿期的疗效,为NAION水肿期综合治疗选择最佳方案。方法对确诊NAION,病程2周内,眼底检查,荧光素眼底血管造影(FFA)及视盘光学相干断层扫描(OCT)确诊为水肿期患者352例361眼,除D组(门诊口服泼尼松激素治疗组)33例33眼,E组(内科对因治疗组)31例32眼外,288例296眼NAION患者住院治疗期间随机分为A组(甲泼尼龙静脉冲击联合血管扩张剂)93例97眼,B组(甲泼尼龙冲击联合脱水剂)114例116眼,C组(甲泼尼龙冲击联合小牛血去蛋白提取物)81例83眼,A、B、C组均配合复方樟柳碱颞浅皮下注射10d,治疗14～16d,再次进行以视力、视野、眼底照相以及OCT为指标的统计分析。结果各治疗组间,C组疗效优于A组、B组、D组;A、B组与D组相比差异不明显;A、B、C、D四组与E组相比差异均有统计学意义。结论甲泼尼龙静脉冲击联合小牛血去蛋白提取物的治疗方案在NAION水肿期的应用对改善水肿,恢复视功能有积极意义。
Objective To evaluate the effectiveness of different comprehensive treatment strategies on patients with nonarteritic anterior ischemic optic neuropathy(NAION) at edema stage.Methods 352 cases(361 eyes) corresponded to the diagnosis criteria for NAION at acute stage and within 2 weeks,and judged by color photograph and FFA examination with optic disc edema,and detected by OCT were enrolled.Except D group(oral prednisone hormone therapy) 33 outpatient cases 33 eyes,and group E(internal medicine treatment) 31 outpatient cases of 32 eyes,patients were randomly divided into group A(methyl-prednisone vein impact joint vasodilators) 93 inpatient cases of 97 eyes,group B(methyl-prednisone impact joint dehydration reagent) 114 inpatient cases 116 eyes,C(methyl-prednisone impact joint mavericks blood to protein extracts) 81 inpatient cases of 83 eyes.All groups were analyzed by visual faction,photographic tomography and OCT after treatment within 14-16 days.Results After different comprehensive treatments on NAION in each group,the recovery in group C is better than group A,group B or group D from visual faction,photographic tomography and OCT changes observation,groups A and B compared with group D were no obvious difference;A,B,C,D groups compared with group E were statistically significant.Conclusions Methyl prednisone venous blood joint impact mavericks blood to protein extracts treatment on NAION at edema period is positive to improve visual function and revolving the optic disc edema,and is a safe,effective,comprehensive method to cure NAION.
出处
《中华临床医师杂志（电子版）》
CAS
2011年第12期3469-3476,共8页
Chinese Journal of Clinicians(Electronic Edition)
基金
陕西省卫生厅科研基金资助项目(04AC1)
