中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
Chinese Journal of Clinicians (Electronic Edition)
2015年
17期
3225-3229
,共5页
综合疗法%视神经病变,缺血性%治疗效果
綜閤療法%視神經病變,缺血性%治療效果
종합요법%시신경병변,결혈성%치료효과
Comprehensive treatment%Optic neuropathy,ischemic%Treatment effect
目的：观察综合治疗前部缺血性视神经病变的临床疗效。方法收集2014年1月至2015年6月来山西医科大学第一附属医院就诊的前部缺血性视神经病变患者40例（42眼）作为研究对象。所有患者均积极治疗全身疾病，同时全身及局部给予激素、扩血管、神经营养药物以及颞浅动脉旁注射复方樟柳碱等综合治疗，以15 d为一个疗程，随访观察30～45 d。结果40例（42眼）患者中，男25例，女15例；发病年龄42～71岁，平均为55.52岁，伴高血压病者24例、糖尿病者10例、高脂血症者22例，有吸烟史者18例。就诊时间最短者2 d，最长者1个月，平均11.48 d。40例（42眼）患者治疗15 d后视力有显著提高（P＜0.01），随访观察30～45 d后视力较治疗15 d时提高（P=0.029）；治疗前平均视野缺损值为（16.14±5.05）dB，治疗15 d后平均视野缺损值为（11.56±3.74）dB，明显降低（t=12.63，P＜0.01），随访观察30～45 d时平均视野缺损值（9.53±3.89） dB，较治疗15 d时降低（t=8.94，P＜0.01）；随访观察30～45 d后总有效率（90.48%）与治疗15 d时总有效率（78.57%）比较，P=0.113，尚不能认为差异有统计学意义。结论综合治疗前部缺血性视神经病变的临床疗效显著，能有效提高患眼视力，降低视野缺损，明显减轻视盘水肿程度。
目的：觀察綜閤治療前部缺血性視神經病變的臨床療效。方法收集2014年1月至2015年6月來山西醫科大學第一附屬醫院就診的前部缺血性視神經病變患者40例（42眼）作為研究對象。所有患者均積極治療全身疾病，同時全身及跼部給予激素、擴血管、神經營養藥物以及顳淺動脈徬註射複方樟柳堿等綜閤治療，以15 d為一箇療程，隨訪觀察30～45 d。結果40例（42眼）患者中，男25例，女15例；髮病年齡42～71歲，平均為55.52歲，伴高血壓病者24例、糖尿病者10例、高脂血癥者22例，有吸煙史者18例。就診時間最短者2 d，最長者1箇月，平均11.48 d。40例（42眼）患者治療15 d後視力有顯著提高（P＜0.01），隨訪觀察30～45 d後視力較治療15 d時提高（P=0.029）；治療前平均視野缺損值為（16.14±5.05）dB，治療15 d後平均視野缺損值為（11.56±3.74）dB，明顯降低（t=12.63，P＜0.01），隨訪觀察30～45 d時平均視野缺損值（9.53±3.89） dB，較治療15 d時降低（t=8.94，P＜0.01）；隨訪觀察30～45 d後總有效率（90.48%）與治療15 d時總有效率（78.57%）比較，P=0.113，尚不能認為差異有統計學意義。結論綜閤治療前部缺血性視神經病變的臨床療效顯著，能有效提高患眼視力，降低視野缺損，明顯減輕視盤水腫程度。
목적：관찰종합치료전부결혈성시신경병변적림상료효。방법수집2014년1월지2015년6월래산서의과대학제일부속의원취진적전부결혈성시신경병변환자40례（42안）작위연구대상。소유환자균적겁치료전신질병，동시전신급국부급여격소、확혈관、신경영양약물이급섭천동맥방주사복방장류감등종합치료，이15 d위일개료정，수방관찰30～45 d。결과40례（42안）환자중，남25례，녀15례；발병년령42～71세，평균위55.52세，반고혈압병자24례、당뇨병자10례、고지혈증자22례，유흡연사자18례。취진시간최단자2 d，최장자1개월，평균11.48 d。40례（42안）환자치료15 d후시력유현저제고（P＜0.01），수방관찰30～45 d후시력교치료15 d시제고（P=0.029）；치료전평균시야결손치위（16.14±5.05）dB，치료15 d후평균시야결손치위（11.56±3.74）dB，명현강저（t=12.63，P＜0.01），수방관찰30～45 d시평균시야결손치（9.53±3.89） dB，교치료15 d시강저（t=8.94，P＜0.01）；수방관찰30～45 d후총유효솔（90.48%）여치료15 d시총유효솔（78.57%）비교，P=0.113，상불능인위차이유통계학의의。결론종합치료전부결혈성시신경병변적림상료효현저，능유효제고환안시력，강저시야결손，명현감경시반수종정도。
ObjectiveTo observe the clinical effect of comprehensive treatment of anterior ischemic optic neuropathy.MethodsFrom January 2014 to July 2015, 42 eyes of 40 patients with anterior ischemic optic neuropathy in First Hospital of Shanxi Medical University were used as the research objects. All the patients were actively controlled systemic disease, at the same time given systemic and local comprehensive therapies, such as glucocorticoid hormone, vasodilator, neurotrophic drugs and compound anisodine injected around superficial temporal artery, with 15 days for a course of treatment, then followed up for 30-45 days.ResultsIn 40 cases (42 eyes) of the patients, 25 males and 15 females, the age ranged from 42 to 71 years with an average age of 55.52 years. Among them, 24 patients were hypertension, 10 patients with diabetes, 22 patients with hyperlipidemia, and 18 patients with a history of smoking. The shortest time was 2 days, the longest was 1 month, and the average was 11.48 days. Visual acuity of 42 eyes was improved significantly after 15 days treatment (P<0.01). After a follow-up observation of 30-45 days, visual acuity improved more significantly than 15 days treatment (P=0.029). Before treatment the mean visual field defect was (16.14±5.05) dB, but it was (11.56±3.74) dB after 15 days treatment, which was significantly reduced (t=12.63,P<0.01). Then after a 30-45 days follow-up observation, the mean visual field defect was (9.53±3.89) dB, lower than 15 days treatment (t=8.94, P<0.01). Compared the total effective rate of 90.48% (30-40 days follow-up observation) with 78.57% (15 days treatment), it was not considered to be statistically significant (P=0.113).Conclusion The comprehensive treatment of anterior ischemic optic neuropathy has a significant effect, can effectively improve the vision, reduce the field defect and significantly reduce the optic papilla edema.
