糖尿病性动眼神经病变的治疗

Treatment of diabetic oculomotor neuropathies

目的探讨不同的治疗方法对糖尿病性动眼神经病变所致眼外肌功能的影响。方法选取了明确诊断的17例糖尿病动眼神经病变患者,随机分为球后注射治疗组(n=8)和常规治疗组(n=9),分别进行甲钴胺药物球后注射和常规静脉药物治疗。比较了两组治疗方法对患眼功能恢复的影响。观察指标有患眼睑裂、眼周疼痛、第一斜视角、眼球运动和复视等指标。结果在第一疗程结束时比较两组患者上睑下垂(U=4.00)、眼周疼痛(U=12.00),差异均有显著性意义(P<0.05);在第二疗程结束时比较两组患者第一斜视角(U=14.00)、眼球运动(U=18.00)及复视程度(U=15.00),差异均有显著性意义(P<0.05)。结论球后药物治疗对糖尿病性动眼神经麻痹的改善有明显的促进作用。

Objective To explore the effect of extraocular muscle function following different treatments procedures on diabetic oculomotor neuropathies.Methods Recruited were 17 diabetic oculomotor nerve palsy patients.All subjects were divided into two groups randomly.One group（n=8） was received retrobulbar injection Mecobalamin（1.0mg）,the other one（n=9） was intravenous administrated Mecobalamin（1.0mg）.The effect on the affected eye function was compared before and after treatment,including palpebral fissure,periorbital pain,primary deviation,ductions and diplopia by objective and subjective methods.Results The function scale was assessed for 17 patients.The mean of ranks of the scores of ptosis（U=4.00） and periorbital pain（U=12.00） were statistically significantly lower for the retrobulbar injected group compared with the conventional therapy group at the first session.At second session,the mean of ranks of the scores of primary deviation（U=14.00）,ductions（U=18.00） and diplopia（U=15.00） were statistically significantly lower for the retrobulbar injected group compared with the conventional therapy group（P0.05）.Conclusions The retrobulbar Mecobalamin injection techniques provide an efficient and straightforward method to improve the affected eye function recovery for diabetic oculomotor neuropathies.