单侧动眼神经麻痹38例临床特点分析

Clinical characteristics of unilateral oculomotor paralysis:a study on 38 cases

目的分析单侧动眼神经麻痹的临床特点。方法收集郑州市第二人民医院2017年1月至2021年8月收治的38例单侧动眼神经麻痹患者的临床资料,设计基线资料调查表,详细记录患者临床症状及体征、病因、性别、年龄等信息,并对疾病的临床特点进行分析。结果38例单侧动眼神经麻痹患者中,主要临床症状及体征为复视(100.00%,38/38),眼外斜(92.11%,35/38),眼球向上、下、内转受限(89.47%,34/38),眼睑下垂(55.26%,21/38);主要发病原因为糖尿病(39.47%,15/38)、脑干血管病变(31.58%,12/38)及动脉瘤(10.53%,4/38);38例患者中,男20例(52.63%,20/38),女18例(47.37%,18/38),差异未见统计学意义(P>0.05);38例单侧动眼神经麻痹患者主要集中于50岁以上年龄段,其中50~59岁、60~69岁年龄段占比较高,分别为31.58%(12/38)、28.95%(11/38)。结论单侧动眼神经麻痹患者主要临床症状及体征为复视,眼外斜,眼球向上、下、内转受限及眼睑下垂,主要发病原因为糖尿病、脑干血管病变及动脉瘤,男女发病率未见明显差异,且多见于50岁及以上年龄段。

Objective To analyze the clinical characteristics of unilateral oculomotor paralysis.Methods The clinical data of 38 patients with unilateral oculomotor paralysis treated in Zhengzhou Second Hospital from January 2017 to August 2021 were collected.The baseline data questionnaire was designed;the clinical symptoms and signs,etiology,gender,age were recorded in detail;and the clinical characteristics of the disease were analyzed.Results Among the 38 patients with unilateral oculomotor paralysis,the main clinical symptoms and signs were diplopia(100.00%,38/38),abtorsion(92.11%,35/38),restricted upward,downward and internal rotation of the eyeball(89.47%,34/38),and ptosis(55.26%,21/38);the main causes of the disease were diabetes mellitus(39.47%,15/38),brainstem vascular lesions(31.58%,12/38)and aneurysms(10.53%,4/38).Among the 38 patients,20 patients were male(52.63%,20/38)and 18 patients were female(47.37%,18/38),without significant difference(P>0.05).The 38 patients with unilateral oculomotor paralysis were mainly in the age group of 50 years and older,while patients aged 50-59 years(31.58%,12/38)and 60-69 years(28.95%,11/38)accounted for a relatively high proportion.Conclusions The main clinical symptoms and signs of unilateral oculomotor paralysis are diplopia,abtorsion,limited upward,downward and internal rotation of the eyeball,and ptosis;the main causes of the disease are diabetes mellitus,brainstem vascular lesions and aneurysms.There is no obvious difference in the incidence of men and women,and it is more common in the age group of 50 years and above.