超选择性眼动脉介入溶栓治疗视网膜中央动脉阻塞的临床效果

Clinical effect of superselective ophthalmic artery interventional thrombolysis in the treatment of central retinal artery occlusion

目的探讨超选择性眼动脉介入溶栓治疗视网膜中央动脉阻塞(CRAO)的临床效果。方法选取2018年1月至2020年12月我院收治的50例CRAO患者作为研究对象,以数字表法随机将其分为对照组和观察组,各25例。对照组采用常规治疗,观察组在常规治疗基础上应用超选择性眼动脉介入溶栓治疗。比较两组的临床疗效、视力、臂-视网膜循环时间(A-Rct)、视网膜动脉主干-分支末梢充盈时间(FT)、凝血功能指标[凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、血浆黏度]、血小板参数[血小板计数(PLT)、平均血小板体积(MPV)、血小板体积分布宽度(PDW)]。结果观察组的治疗总有效率为96.00%,显著高于对照组的76.00%,差异具有统计学意义(P<0.05)。治疗前,两组的视力、A-Rct及FT比较,差异无统计学意义(P>0.05);治疗后,观察组的视力高于对照组,A-Rct、FT短于对照组,差异具有统计学意义(P<0.05)。治疗前,两组的TT、PT、APTT、FIB水平、血浆黏度比较,差异无统计学意义(P>0.05);治疗后,观察组的TT、PT、APTT长于对照组,FIB水平、血浆黏度低于对照组,差异具有统计学意义(P<0.05)。治疗前,两组的PLT、MPV、PDW比较,差异无统计学意义(P>0.05);治疗后,观察组的MPV、PLT、PDW低于对照组,差异具有统计学意义(P<0.05)。结论超选择性眼动脉介入溶栓治疗CRAO患者的临床效果显著,可促进患者视力改善,也能进一步改善其凝血功能指标及血小板参数,值得推广。

Objective To investigate the clinical effect of superselective ophthalmic artery interventional thrombolysis in the treatment of central retinal artery occlusion(CRAO).Methods A total of 50 patients with CRAO admitted in our hospital from January 2018 to December 2020 were selected as the study objects.The patients were randomly divided into control group and observation group according to the digital table method,with 25 cases in each group.The control group was given conventional therapy,and the observation group was given superselective ophthalmic artery interventional thrombolysis on the basis of conventional therapy.The clinical efficacy,visual acuity,arm-retinal circulation time(A-Rct),retinal artery trunk-branch peripheral filling time(FT),coagulation function indexes[thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),plasma viscosity],platelet parameters[platelet count(PLT),mean platelet volume(MPV),platelet volume distribution width(PDW)]were compared between the two groups.Results The total effective rate of treatment of the observation group was 96.00%,which was significantly higher than 76.00%of the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in visual acuity,A-Rct and FT between the two groups(P>0.05);after treatment,the visual acuity of the observation group was higher than that of the control group,the A-Rct and FT were shorter than those of the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in TT,PT,APTT,FIB levels and plasma viscosity between the two groups(P>0.05);after treatment,TT,PT and APTT in the observation group were longer than those in the control group,FIB level and plasma viscosity were lower than those in the control group,and the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in PLT,MPV and PDW between the two groups(P>0.05);after treatment,MPV,PLT and PDW in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Superselective ophthalmic artery interventional thrombolysis in the treatment of CRAO patients has remarkable clinical effect,it can promote the improvement of the visual acuity,and further improve the coagulation function indexes and platelet parameters,which is worthy of promotion.