地塞米松球旁注射治疗前部缺血性视神经病变的临床研究

Clinical research for the treatment of anterior ischemic optic neuropathy by periglomerular injection of dexamethasone

目的:探讨地塞米松球旁注射治疗前部缺血性视神经病变的疗效,比较与全身用药的优势,特别是在减轻不良反应方面。方法:将132例患者随机分为两组:球旁注射组74例,全身用药组58例。对照组选择神经内科动脉硬化脑血管痉挛或腔隙性脑梗塞的患者59例。球旁注射组2.5mg地塞米松患眼球旁注射7d;全身用药组10mg地塞米松静脉滴注5～7d减量;对照组不用地塞米松。三组患者均全身应用扩张血管药物及营养神经药物。治疗后4～7d检查视力、视野、体质量变化,了解不良反应。结果:地塞米松球旁注射组和全身用药组患者视力、视野均有显著提高。对照组视力视野略有提高。全身用药组食欲亢进、乏力、失眠、体质量增加等不良反应明显。结论:地塞米松球旁注射治疗缺血性视神经病变疗效显著,不良反应少,值得基层医院推广。

· AIM： To explore the effects of periglomerular injection of dexamethasone in anterior ischemic optic neuropathy,and compare with systemic administration of superiority, especially in reducing adverse reactions.· METHODS： Totally 132 patients were randomly divided into the periglomerular injection group （n = 74） giving periglomerular injection of 2.5rag dexamethasone for 7 days and systemic administration group （ n = 58） giving dexamethasone lOmg intravenous for 5 or 7 days. 59 patients of with cerebral vasospasm or lacunar infarction in department of neurology were selected as control group not giving dexamethasone. Three groups of patients were given systemic enlarging vascular drugs and nutrition nerve drugs. We checked visual acuity, visual fields, weight change, and learned the adverse reactions 4 to 7 days after treatment.· RESULTS： Both visual acuity and field of vision were significantly improved in periglomerular of dexamethasone injection group and systemic administration group. Visual acuity and Visual fields of the control group increased slightly. Appetite hyperactivity, fatigue, insomnia, weight gain and other adverse reactions were distinctly in systemic administration group. · CONCLUSION： It is worth spreading of the primary hospital that the treatment of anterior ischemic optic neuropathy by periglomerular injection of dexamethasone.