Tenon氏囊后部曲安奈德注射治疗儿童视神经炎的疗效及安全性观察

Efficacy and safety of Tenon's posterior capsule triamcinolone injection in treatment of optic neuritis in children

目的观察后Tenon囊下注射曲安奈德治疗儿童视神经炎的临床效果及安全性。方法选取2018年6月—2023年6月郑州市第七人民医院收治的60例(120眼)儿童视神经炎患者,随机方式进行分组,分为曲安奈德后Tenon下注射的观察组与全身应用糖皮质激素类固醇的对照组,每组均用甲钴胺、胞磷胆碱钠胶囊及复方樟柳碱注射液颞浅动脉旁皮下注射。两组患儿基线特征接近。对两组治疗1个月及3个月后的临床疗效、视觉诱发电位(visual evoked potential,VEP)、视野、光敏度、CFF-红色、绿色、黄色值检查结果进行统计分析。结果治疗1个月后效果观察显示,观察组总有效率(96.66%)优于对照组(78.33%)(P<0.05);观察组VEP检查显示P100波振幅为(7.58±3.54)μV,高于对照组[(6.78±3.18)μV](P<0.05),观察组潜伏期(91.58±13.82)ms,低于对照组[(97.20±15.66)ms](P<0.01);观察组平均视野缺损(0.54±0.33)dB,低于对照组[(0.63±0.28)dB](P<0.01);观察组平均光敏度(22.46±3.86)dB,高于对照组[(24.87±4.17)dB](P<0.01);观察组CFF-红色、绿色、黄色平均值[(29.64±6.94、31.66±8.42、32.64±7.68)Hz]高于对照组[(28.76±5.12、29.65±3.22、30.62±7.12)Hz],组间对比差异有统计学意义(P<0.01)。结论后Tenon囊下注射曲安奈德治疗儿童视神经炎安全有效,无不良反应,适用基层医院推广应用。

Objective To observe the clinical effect and safety of Tenon subcapsular injection of triamcinolone in the treatment of optic neuritis in children.Methods A total of 60 children(120 eyes)with optic neuritis admitted to Zhengzhou Seventh People's Hospital from June 2018 to June 2023 were randomly divided into an observation group receiving Tenon injection after triamcinolone and a control group receiving systemic glucocorticoid steroids.Mecobalamine,citicoline sodium capsules and compound anisodine injection were given subcutaneous injection at the superficial temporal artery in each group.Baseline characteristics were similar between the two groups.Clinical efficacy,visual evoked potential(VEP),visual field,photosensitivity,CFF-red,green and yellow values were statistically analyzed after 1 month and 3 months of treatment in the two groups.Results After 1 month of treatment,the total effective rate of the observation group(96.66%)was better than that of the control group(78.33%)(P<0.05).VEP examination showed that the P100 wave amplitude of the observation group was(7.58±3.54)μV,higher than that of the control group[(6.78±3.18)μV](P<0.05),and the latency of the observation group was(91.58±13.82)ms,lower than that of the control group[(97.20±15.66)ms](P<0.01).The average visual field defect in the observation group was(0.54±0.33)dB,lower than that in the control group[(0.63±0.28)dB](P<0.01).The average photosensitivity of observation group was(22.46±3.86)dB,which was higher than that of control group[(24.87±4.17)dB](P<0.01).The mean value of CFF-red,green and yellow[(29.64±6.94,31.66±8.42,32.64±7.68)Hz]in observation group was higher than that in control group[(28.76±5.12,29.65±3.22,30.62±7.12)Hz].The difference between groups was statistically significant(P<0.01).Conclusion Post Tenon subcapsular injection of triamcinolone acetonide is safe and effective in the treatment of pediatric optic neuritis,with no adverse reactions,and is suitable for promotion and application in grassroots hospitals.