复方樟柳碱联合后Tenon囊下注射曲安奈德治疗前部缺血性视神经病变

Therapeutic effect observation of compound anisodine combined with triamcinolone acetonide by anterior Tenon capsule injection for anterior ischemic optic neuropathy

目的:观察复方樟柳碱联合后Tenon囊下注射曲安奈德治疗前部缺血性视神经病变的疗效。方法:临床确诊的前部缺血性视神经病变患者58例60眼随机分为两组,其中29例30眼接受复方樟柳碱侧颞浅动脉旁注射联合曲安奈德20mg后Tenon囊下注射(治疗组);另外29例30眼采用复方樟柳碱侧颞浅动脉旁注射治疗(对照组);均以15d为1个疗程。两组患者用药后每天观察视力变化及视乳头水肿消退情况,治疗前有视野者复查视野。结果:治疗15d后,两组视力,视野及视乳头水肿情况均有不同程度改善,治疗组视力提高程度明显高于对照组,两组间差异有统计学意义(χ2=17.8,P<0.01);治疗组有视野检查的14眼中治疗后好转12眼(86%),2眼无变化(14%);对照组有视野检查的13眼中治疗后视野好转4眼(31%),9眼无变化(69%),两组视野变化比较差异有统计学意义(χ2=8.68,P<0.05)。结论:复方樟柳碱联合曲安奈德治疗AION优于单纯复方樟柳碱治疗。

AIM： To observe the therapeutic effect of compound anisodine combined with triamcinolone acetonide（TA） for anterior ischemic optic neuropathy（AION）. METHODS： Totally 58 patients 60 eyes diagnosed with AION were randomly divided into two groups： 29 patients 30 eyes underwent superficial temporal artery injection with compound anisodine combined with triamcinolone acetonide（TA）（20mg） posterior Tenons capsule injection （treatment group）,and the other 29 patients 30 eyes underwent superficial temporal artery injection with compound anisodine （2mL/d）（control group） with the period of treatment of 15 days. The changes of visual acuity and optic papilla swelling were recorded after treatment. The visual field was counterchecked in the patients who had underwent the examination before the treatment. RESULTS： The visual acuity was improved in treatment group more than that in control group and there was statistical difference（χ^2=17.8,P〈0.01）. In treatment group 14 eyes underwent the examination of vision field and improved in 12 （86%） and remainded unchanged in 2（14%）. In control group 13 eyes underwent the examination of vision field and improved in 4（31%） and remainded unchanged in 9（69%）. The change of vision field between two groups was statistical different （χ^2=868,P〈0.05）. CONCLUSION： Compound anisodine combined with TA is more effective than compound anisodine separately on AION. 