中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2010年
7期
738-741
,共4页
吴航%刘大川%吉训明%张旭香%杨慧清
吳航%劉大川%吉訓明%張旭香%楊慧清
오항%류대천%길훈명%장욱향%양혜청
视网膜中央动脉阻塞%眼底荧光血管造影%选择性眼动脉溶栓%常规治疗
視網膜中央動脈阻塞%眼底熒光血管造影%選擇性眼動脈溶栓%常規治療
시망막중앙동맥조새%안저형광혈관조영%선택성안동맥용전%상규치료
Central retinal artery occlusion%Fundus fluorescein angiography%Selective intra-arterial fibrinolysis%Conventional conservative treatment
目的 通过对比选择性眼动脉溶栓及传统常规治疗视网膜中央动脉阻塞.治疗前后眼底荧光血管造影,了解两种治疗方法对视网膜中央动脉血供改善效果.方法 收集病人为非随机对照,根据患者是否同意溶栓或有溶栓禁忌证分为介入溶栓组及常规治疗组,记录所有患者年龄、性别、全身病、发病到治疗时间、患眼眼底检查、治疗前眼底荧光血管造影、治疗48h及1月后的眼底及荧光血管造影结果.对比治疗前后荧光血管造影臂-视网膜显影时间、视网膜动-静脉显影时间.结果 溶栓治疗组发病时臂-视网膜显影时间及视网膜动-静脉显影时间明显延长分别为(28.76±6.81)s及(40.44±8.48)s,治疗48h及1m后复查显示臂-视网膜显影时间(15.36±4.03)s和(15.84±3.42)s,视网膜动-静脉显影时间(22.28±4.63)s和(21.72 4±3.55)s,与治疗前对比显著缩短,差异有统计学意义.常规治疗组发病时臂-视网膜显影时间及视网膜动一静-脉显影时间亦明显延长分别为(29.81±6.08)s及(38.33±7.41)s,治疗48h后臂-视网膜显影时间及视网膜动-静脉显影时间(29.19±6.27)s及(37.85±7.79)s,与治疗前对比差异无统计学意义,治疗1月后臂-视网膜显影时间及视网膜动-静脉显影时间(24.38±6.69)s及(33.56±6.43)s,较治疗前缩短差异有统计学意义,但仍较溶栓组显影时间延长.眼底检查1月复查时均出现视网膜神经纤维层及视盘不同程度萎缩,但常规治疗组损害更重.结论 选择性眼动脉溶栓治疗视网膜中央动脉阻塞可较常规治疗方法更及时有效恢复视网膜血供,缩短眼底荧光血管造影的臂-视网膜显影及视网膜动-静脉充盈时间,但即使迅速恢复了视网膜中央动脉血供,仍可会出现视网膜神经组织不同程度的组织形态学损害.
目的 通過對比選擇性眼動脈溶栓及傳統常規治療視網膜中央動脈阻塞.治療前後眼底熒光血管造影,瞭解兩種治療方法對視網膜中央動脈血供改善效果.方法 收集病人為非隨機對照,根據患者是否同意溶栓或有溶栓禁忌證分為介入溶栓組及常規治療組,記錄所有患者年齡、性彆、全身病、髮病到治療時間、患眼眼底檢查、治療前眼底熒光血管造影、治療48h及1月後的眼底及熒光血管造影結果.對比治療前後熒光血管造影臂-視網膜顯影時間、視網膜動-靜脈顯影時間.結果 溶栓治療組髮病時臂-視網膜顯影時間及視網膜動-靜脈顯影時間明顯延長分彆為(28.76±6.81)s及(40.44±8.48)s,治療48h及1m後複查顯示臂-視網膜顯影時間(15.36±4.03)s和(15.84±3.42)s,視網膜動-靜脈顯影時間(22.28±4.63)s和(21.72 4±3.55)s,與治療前對比顯著縮短,差異有統計學意義.常規治療組髮病時臂-視網膜顯影時間及視網膜動一靜-脈顯影時間亦明顯延長分彆為(29.81±6.08)s及(38.33±7.41)s,治療48h後臂-視網膜顯影時間及視網膜動-靜脈顯影時間(29.19±6.27)s及(37.85±7.79)s,與治療前對比差異無統計學意義,治療1月後臂-視網膜顯影時間及視網膜動-靜脈顯影時間(24.38±6.69)s及(33.56±6.43)s,較治療前縮短差異有統計學意義,但仍較溶栓組顯影時間延長.眼底檢查1月複查時均齣現視網膜神經纖維層及視盤不同程度萎縮,但常規治療組損害更重.結論 選擇性眼動脈溶栓治療視網膜中央動脈阻塞可較常規治療方法更及時有效恢複視網膜血供,縮短眼底熒光血管造影的臂-視網膜顯影及視網膜動-靜脈充盈時間,但即使迅速恢複瞭視網膜中央動脈血供,仍可會齣現視網膜神經組織不同程度的組織形態學損害.
목적 통과대비선택성안동맥용전급전통상규치료시망막중앙동맥조새.치료전후안저형광혈관조영,료해량충치료방법대시망막중앙동맥혈공개선효과.방법 수집병인위비수궤대조,근거환자시부동의용전혹유용전금기증분위개입용전조급상규치료조,기록소유환자년령、성별、전신병、발병도치료시간、환안안저검사、치료전안저형광혈관조영、치료48h급1월후적안저급형광혈관조영결과.대비치료전후형광혈관조영비-시망막현영시간、시망막동-정맥현영시간.결과 용전치료조발병시비-시망막현영시간급시망막동-정맥현영시간명현연장분별위(28.76±6.81)s급(40.44±8.48)s,치료48h급1m후복사현시비-시망막현영시간(15.36±4.03)s화(15.84±3.42)s,시망막동-정맥현영시간(22.28±4.63)s화(21.72 4±3.55)s,여치료전대비현저축단,차이유통계학의의.상규치료조발병시비-시망막현영시간급시망막동일정-맥현영시간역명현연장분별위(29.81±6.08)s급(38.33±7.41)s,치료48h후비-시망막현영시간급시망막동-정맥현영시간(29.19±6.27)s급(37.85±7.79)s,여치료전대비차이무통계학의의,치료1월후비-시망막현영시간급시망막동-정맥현영시간(24.38±6.69)s급(33.56±6.43)s,교치료전축단차이유통계학의의,단잉교용전조현영시간연장.안저검사1월복사시균출현시망막신경섬유층급시반불동정도위축,단상규치료조손해경중.결론 선택성안동맥용전치료시망막중앙동맥조새가교상규치료방법경급시유효회복시망막혈공,축단안저형광혈관조영적비-시망막현영급시망막동-정맥충영시간,단즉사신속회복료시망막중앙동맥혈공,잉가회출현시망막신경조직불동정도적조직형태학손해.
Objective To investigate whether selective intra-arterial fibrinolysis is mort effective in improving retinal circulation than conservative methods in the treatment of acute central retinal artery occlusion (CRAO) by detection method of fundus fluorescein angiography (EVA).Methods In this retrospecrive study,a total of 52 patients with CRAO were divided into two groups according to the different treatment methods.primary study end point was the results of FFA on 48 hours and 1 month after therapy in comparison with those before therapy between two groups.Results In fibrinolysis group,filling time of retinal arterial and venous lamellar filling on FFA 48 hours and 1 month after therapy were significantly shorter than those before therapy,in conventional group,there were no difference in retinal circulation between before and 48h after therapy,however the improvement of retinal circulation was observed at 1 month after therapy.Optic disk and retinal fiber layer damage were present in all patients with CRAO at 1 month follow up visit.Conclusions Selective intra-arterial fibrinolysis can improve retinal circulation significantly compared with conventional management of CRAO,but morphometric damage in all eyes with CRAO are present.
