CAJ | 학술논문

目的选择性眼动脉溶栓治疗早期视网膜中央动脉阻塞患者治疗前后视力变化的临床研究.方法收集2006年9月至2009年7月经确诊并在发病12h内进行溶栓的视网膜中央动脉阻塞患者.所有患者均记录年龄、性别、全身病史、发病至溶栓时间、眼底镜检查、眼底荧光血管造影(fundus fluorescein angiography,FFA)、术后48 h复查视力、眼底镜检查、眼底荧光血管造影,术后1月复查,记录视力及眼底检查,并进行对比.结果 24例患者发病至溶栓的平均时间(8.39±3.24)h,溶栓治疗前臂一视网膜动脉显影时间明显延长,平均(29.34±7.83)s,治疗48 h后眼底血管造影显示,臂一视网膜动脉充盈时间明显缩短,平均(15.48±4.33)s,与治疗前对比差异显著有统计学意义；治疗后1月,复查荧光血管造影,臂一视网膜动脉显影时间平均为(15.76±3.12)s,与治疗48 h对比无差异.发病时视力低于0.05患者20例占83.3％,0.05～0.1者4例占16.7％,治疗48 h后视力低于0.05患者7例29.2％,0.05～0.1,6例占25％,高于0.1者11例占45.8％,其中2例高于0.5,占8.3％；治疗前及治疗后48 h患眼视力获得提高的病人数量对比变化显著有统计学意义P＜0.01,治疗后1月视力低于0.05患者5例占20.8％,0.05～0.1者6例占25％,超过0.1患者13例占54.2％,与治疗前患者视力相比差异显著有统计学意义.结论局部动脉溶栓治疗视网膜中央动脉阻塞,可及时有效恢复早期阻塞的视网膜神经组织的血流灌注,改善早期视网膜中央动脉阻塞患者的视力,但此研究缺乏与传统治疗方法对照研究,同时该治疗方法还需要多中心大样本的临床对比.
목적 선택성안동맥용전치료조기시망막중앙동맥조새환자치료전후시력변화적림상연구.방법 수집2006년9월지2009년7월경학진병재발병12h내진행용전적시망막중앙동맥조새환자.소유환자균기록년령、성별、전신병사、발병지용전시간、안저경검사、안저형광혈관조영(fundus fluorescein angiography,FFA)、술후48 h복사시력、안저경검사、안저형광혈관조영,술후1월복사,기록시력급안저검사,병진행대비.결과 24례환자발병지용전적평균시간(8.39±3.24)h,용전치료전비일시망막동맥현영시간명현연장,평균(29.34±7.83)s,치료48 h후안저혈관조영현시,비일시망막동맥충영시간명현축단,평균(15.48±4.33)s,여치료전대비차이현저유통계학의의；치료후1월,복사형광혈관조영,비일시망막동맥현영시간평균위(15.76±3.12)s,여치료48 h대비무차이.발병시시력저우0.05환자20례점83.3％,0.05～0.1자4례점16.7％,치료48 h후시력저우0.05환자7례29.2％,0.05～0.1,6례점25％,고우0.1자11례점45.8％,기중2례고우0.5,점8.3％；치료전급치료후48 h환안시력획득제고적병인수량대비변화현저유통계학의의P＜0.01,치료후1월시력저우0.05환자5례점20.8％,0.05～0.1자6례점25％,초과0.1환자13례점54.2％,여치료전환자시력상비차이현저유통계학의의.결론 국부동맥용전치료시망막중앙동맥조새,가급시유효회복조기조새적시망막신경조직적혈류관주,개선조기시망막중앙동맥조새환자적시력,단차연구결핍여전통치료방법대조연구,동시해치료방법환수요다중심대양본적림상대비.
Objective To study the visual acuity improvement in the patients with central retinal artery occlusion (CRAO) by the treatment of intra-arterial thrombolysis in early stage. Methods The study included 24 patients with recent CRAO by the treatment of intra-arterial thrombolysis,the improvement of visual acuity,retinal circulation changes,detailed results of visual acuity and FFA were evaluated and compared at initial and follow- up visits. Results The delay between the onset of symptoms and the initiation of fibrinolytic treatment varied from just under 3.5 h to 12 h in the patients with CRAO,the mean time was 8.39±3.24h,significant improvement of visual acuity and retinal circulation after the treatment was observed. Conclusions Intra-arterial thrombolysis can improve visual acuity and retinal circulation significantly.The execution of randomized,controlled trials is greatly needed