两种方法注射复方樟柳碱治疗前部缺血性视神经病变的疗效比较

Therapeutic Efficacy Comparison of Compound Anisodine by Two Injection Methods in Treatment of Anterior Ischemic Optic Neuropathy

目的比较颞浅动脉旁皮下注射和球后注射复方樟柳碱治疗前部缺血性视神经病变(AION)的疗效。方法应用复方樟柳碱对56例AION患者进行治疗,分别采用颞浅动脉旁皮下注射和球后注射的给药方法。观察用药前后视力、视野及眼底血管的变化,对两组的病例作疗效对比及不良反应的观察。结果治疗后皮下注射组患者视力提高、视野扩大、眼底改善的显效率分别为56.7%、66.7%、70%;球后注射组患者视力提高、视野扩大、眼底改善的显效率分别为57.7%、76.9%、76.9%。两组视力、视野、眼底变化的显效率、有效率、无效率均无统计学差异(P>0.05)。球后注射组的部分患者治疗后出现暂时性瞳孔散大、眼球运动受限及上睑下垂等改变,皮下注射组未出现不良反应。结论颞浅动脉皮下注射复方樟柳碱治疗AION,与球后注射给药有相当的疗效,且不良反应较少。

Objective To compare the therapeutic effect of compound anisodine by subcutaneous injection near the temporal superficial artery or retrobulbar injection in the treatment of Anterior Ischemic Optic Neuropathy. Methods 56 cases with AIOD were treated with compound anisodine. The drug was given by subcutaneous injection near temporal superficial artery or retrobulbar injection. The changes about vision, field of vision and vessels of eye ground were observed before and after administration. Further more, the ther- apeutic effect and side effect were also observed. Results The excellect rate of increased vision, enlarged field of vision and promoted eye ground was 56.7% ,66.7% ,70% in the patients by subcutaneous injection near temporal superficial artery, while the excellent rate of increased vision, enlarged field of vision and promoted eye ground was 57.7% ,76.9% ,76.9% in the patients by retrobulbar injection. There was on obviouse difference in the excellent rate, effective rate and non-effective rate of two groups （ P 〉 0.05 ）. There were many disadvantages found in the patients with retrohulbar injection, such as temporary corectasis,limited ocular movement, lapsus palpebrae superioris and so on. There was no side effect found in the group with subcutaneous injection. Conclusion The method using compound anisodine by subcutaneous injection to treat AION has the similar effect of retrobulbar injection with less side effect.