高压氧疗联合复方樟柳碱治疗视神经挫伤的临床观察

Clinical study of hyperbaricoxygentherapy combined with compound anisodine for optic nerve contusion

目的观察高压氧联合复方樟柳碱治疗视神经挫伤的临床疗效。方法选取自2014年10月—2016年3月于郑州市第二人民医院门诊治疗的视神经挫伤患者(156例196眼)为研究对象,将其随机分为A组:即常规治疗组(52例70眼),采用糖皮质激素冲击治疗,同时给予胞二磷胆碱针,维生素及能量合剂等;B组:复方樟柳碱组(52例63眼),在常规治疗的基础上,给予复方樟柳碱注射液颞浅动脉旁皮下治疗,1次/d,每次2ml;C组,高压氧联合复方樟柳碱组(52例63眼),在常规治疗和复方樟柳碱的基础上,给予高压氧疗,高压氧动力为2~2.3ATA,吸纯氧90min,中间吸一次空气5min,1次/d,氧疗前30min口服硝酸甘油片扩张血管。三组均以14d为一个疗程,共治疗3个疗程。分别观察比较各组患者治疗前后视力、眼底及P-VEP改善状况为指标,根据各组的有效率评价疗效。结果治疗后C组视力、眼底及P-VEP改善情况显著优于A组和B组(P<0.05);A组、B组和C组的总有效率分别为64.3%、79.4%和92.1%,经比较C组的有效率显著高于A组和B组(P<0.05);在治疗中三组均无明显不良反应发生。结论采用高压氧联合复方樟柳碱对视神经挫伤患者的视力、眼底和P-VEP有明显的改善作用,是一种安全、有效的治疗方法。

Objective To investigate clinical results of hyperbaricoxygentherapy combined with compound anisodine for optic nerve contusion. Methods In October 2014-March 2016,156 cases（196 eyes） of optic nerve contusion patients admitted to the outpatients in our hospital for the clinical study and were randomly divided into group A（conventional treatment group,52 cases 70 eyes）,group B（compound anisodine group,52 cases 63 eyes） and group C（hyperbaricoxygentherapy combined with compound anisodine group,52 cases 63 eyes）. The period of treatment was three courses（two weeks for one course）. After three courses of treatment,we compared visual acuity,fundus and P-VEP changes of each groups and observed the security of hyperbaricoxygentherapy combined with compound anisodine for optic nerve contusion. Results After treatment,visual acuity,fundus and P-VEP changes of group C was significantly better than group A and group B; total effective rate of group A,group B and group C were separately 64. 3%,79. 4%and 92. 1%,and the difference was statistically significant（P〈0. 05）. During treatment,it showed no significant adverse reactions. Conclusion The use of hyperbaricoxygentherapy combined with compound anisodine for optic nerve contusion is efficient and safe.