甲钴胺离子导入联合复方樟柳碱颞浅动脉旁注射治疗眼肌麻痹

Mecobalamin ion transmission combined compound anisodine injection near superficial temporal artery for ophthalmoplegia

目的探讨甲钴胺离子导入联合复方樟柳碱颞浅动脉旁注射治疗眼肌麻痹的临床疗效。方法回顾性分析75例眼肌麻痹患者的临床资料,按照治疗方法分为3组。联合用药组30例,患者患侧颞浅动脉旁注射复方樟柳碱注射液2 mL,同时患眼甲钴胺注射液500μg离子导入,每天1次。甲钴胺组25例,患眼甲钴胺注射液500μg离子导入,每天1次。复方樟柳碱组20例,患侧颞浅动脉旁注射复方樟柳碱注射液2 mL,每天1次。以上治疗连续10 d为1疗程,每疗程结束后观察并记录患者的主观症状、眼位偏斜、眼肌运动、复视相及副作用,随访6个月。结果联合用药组治愈率80.0%,高于甲钴胺组52.0%及复方樟柳碱组50.0%,差异均有统计学意义(均为P<0.05),但联合用药组总有效率(86.7%)与甲钴胺组(80.0%)及复方樟柳碱组(85.0%)比较差异均无统计学意义(χ2=0.442 8,P=0.505 8;χ2=0.277 0,P=0.867 9)。联合用药组治愈时间(29.5±12.6)d,较甲钴胺组和复方樟柳碱组分别缩短约10 d和11 d,差异均有统计学意义(均为P<0.05)。甲钴胺组和复方樟柳碱组的治愈率、总有效率和治愈时间之间差异均无统计学意义(均为P>0.05)。治疗中无注射部位硬结、出血等发生。结论甲钴胺离子导入联合复方樟柳碱颞浅动脉旁注射,可提高眼肌麻痹患者治愈率,缩短治疗时间,安全有效,而副作用没有增加。

Objective To discuss the clinical effects of mecobalamin ion transmission combined compound anisodine injection near superficial temporal artery in the treatment of ophthalmoplegia. Methods Clinical data of 75 patients with ophthalmoplegia were analyzed retrospectively. All patients were divided into three groups. Patients in combined group（ n = 30） were administrated with 2 mL compound anisodine injection near superficial temporal artery plus 500 μg mecobalamin ion transmission. Patients in mecobalamin group（ n = 25） and compound anisodine group（ n = 20） were administered with 500 μg mecobalamin by ion transmission and 2 mL compound anisodine by near superficial temporal artery respectively. Each case received the treatment once a day and a treatment course was 10 continuous days. Symptoms,eye position deviation,muscle movement and diplopia were monitored in the end of treatment course and the side effects in general or locally also observed. Results The cure rate in combined group was 80. 0%,which was higher than that in both mecobalamin group（ 52. 0%） and compound anisodine group（ 50.0%）（ all P〈0. 05）,but the total efficiency difference was not significant among three combined group（ 86. 7%）,mecobalamin group（ 80. 0%） and compound anisodine group（ 85. 0%）（ χ2=0. 442 8,P = 0. 505 8; χ2= 0. 277 0,P = 0. 867 9）. The mean duration of cured time in combined group was（ 29. 5 ± 12. 6） days,which was shorter than those in both mecobalamin group and compound anisodine group about 10 days and 11 days,respectively（ all P〈0. 05）. There were no differences of cured rate,efficiency and treatment duration between mecobalamin group and compound anisodine group（ all P〉0. 05）. There was no local induration,injection site bleeding,and no worsen original disease observed in all three groups. Conclusion Mecobalamin ion transmission combined compound anisodine injection near superficial temporal artery is effective and safe in treatment of ophthalmoplegia,can improve cured rate,shorten therapeutic time,but don＇t increase the side effects.