摘要
目的:探讨以复视为首发症状的眼外肌麻痹患者临床特征及治疗。方法:以复视为首发症状的的眼外肌麻痹患者89例,根据病史、详细的查体和眼部检查,分析其发病原因,并评价临床特征和疗效。根据病因不同除行相关科室治疗外,眼科给以神经营养、眼部和全身激素治疗、大量维生素类和扩血管药物,6～12mo后治疗无效者,行手术治疗。结果:原因:糖尿病32例,高血压动脉硬化10例,甲状腺相关性眼病8例,眼外伤6例,颅内占位性病变6例,眶内占位性病变5例,重症肌无力4例,急性共同性内斜视3例,颈动脉海绵窦瘘3例,副鼻窦肿瘤2例,原因不明10例。动眼神经麻痹致上下直肌、下斜肌、内直肌麻痹49例,外展神经麻痹致外直肌麻痹26例,滑车神经麻痹致上斜肌麻痹12例,动眼神经麻痹和外展神经麻痹引起的眼外肌麻痹2例。结论:以复视为首发症状的急性眼外肌麻痹病因复杂,容易误诊,眼科医生应高度重视,明确诊断,正确治疗。
AIM: To evaluate clinical features and management on patients with acute extr aocular muscles paralysis primarily tolerated diplopia. · METHODS: Eighty-nine cases with acute extraocular muscles paralysis were prev iewed and analyzed on causes of disease according to medical history, a thorough physical examination and a complete eye examination. The clinical features and management were further evaluated. Besides relative treatment of etiology, all p atients were treated with compositive method, including nerve nutrition, glucoco rticoid, sufficient vitamin and vasodilator. Some cases that had not improved af ter 6-12mo of medical treatment underwent operation. · RESULTS: Thirty-two patients with acute extraocular muscles paralysis were ca used by diabetes, 10 by hypertension and arteriosclerosis 8 by Graves, 6 by ocul ar injury, 6 by intracranial spaceoccuping lesion, 5 by eye sockets space occupy ing lesion, 4 by myasthenia gravis, 3 by acute concomitant esotropia, 3 by carot id cavernous fistula and 2 by accessory nasal sinuses tumor. The causes of other 10 were unknown. The types of muscles paralysis include oculomotor nerve paraly sis (49 cases), abducent nerve paralysis (26 cases), trochlear nerve paralysis ( 12 cases), and combination of oculomotor nerve and abducent nerve paralysis (2 c ases). · CONCLUSION: The etiology of patients with acute extraocular muscles paralysis primarily tolerated diplopia is complex and easy to be misjudg. Therefore, much attention should be paid to the exact diagnosis and proper management. ·
出处
《国际眼科杂志》
CAS
2004年第6期1140-1142,共3页
International Eye Science
