Early electrical field stimulation prevents the loss of spinal cord anterior horn motoneurons and muscle atrophy following spinal cord injury

Our previous study revealed that early application of electrical field stimulation（EFS） with the anode at the lesion and the cathode distal to the lesion reduced injury potential, inhibited secondary injury and was neuroprotective in the dorsal corticospinal tract after spinal cord injury（SCI）. The objective of this study was to further evaluate the effect of EFS on protection of anterior horn motoneurons and their target musculature after SCI and its mechanism. Rats were randomized into three equal groups. The EFS group received EFS for 30 minutes immediately after injury at T_（10）. SCI group rats were only subjected to SCI and sham group rats were only subjected to laminectomy. Luxol fast blue staining demonstrated that spinal cord tissue in the injury center was better protected; cross-sectional area and perimeter of injured tissue were significantly smaller in the EFS group than in the SCI group. Immunofluorescence and transmission electron microscopy showed that the number of spinal cord anterior horn motoneurons was greater and the number of abnormal neurons reduced in the EFS group compared with the SCI group. Wet weight and cross-sectional area of vastus lateralis muscles were smaller in the SCI group to in the sham group. However, EFS improved muscle atrophy and behavioral examination showed that EFS significantly increased the angle in the inclined plane test and Tarlov＇s motor grading score. The above results confirm that early EFS can effectively impede spinal cord anterior horn motoneuron loss, promote motor function recovery and reduce muscle atrophy in rats after SCI.

Non-arteritic anterior ischemic optic neuropathy combined with branch retinal vein obstruction:A case report

BACKGROUND Non-arteritic anterior ischemic optic neuropathy(NAION)is an independent disease characterized by edematous optic discs.In eyes with branch retinal vein occlusion(BRVO),the arteries and veins in the ethmoid plate of the optic disc are relatively crowded;however,a combination of the two is clinically uncommon.Herein,we reported a patient with NAION and concealed BRVO,for which the treatment and prognosis were not similar to those for NAION alone.CASE SUMMARY Herein,we report a case of NAION with concealed BRVO that did not improve with oral medication.A week later,we switched to intravenous drug administration to improve circulation,and the patient’s visual acuity and visual field recovered.Hormonal therapy was not administered throughout the study.This case suggested that:(1)Fundus fluorescein angiography(FFA)can help detect hidden BRVO along with the NAION diagnosis;(2)intravenous infusion of drugs to improve circulation has positive effects in treating such patients;and(3)NAION with concealed BRVO may not require systemic hormonal therapy,in contrast with the known treatment for simple NAION.CONCLUSION NAION may be associated with hidden BRVO,which can only be observed on FFA;intravenous therapy has proven effectiveness.

多模型融合的换道意图识别研究

快速准确识别出周围车辆的换道意图对高级自动驾驶辅助系统的决策支持和安全预防具有重要意义。针对现有方法未能充分考虑车辆之间的交互作用以及轨迹数据的前后依赖性问题,提出一种基于多模型融合的换道意图识别框架。该换道意图识别框架主要包括输入处理与换道意图识别两部分。输入处理部分对车辆轨迹数据进行清洗、贴标、切片以及one-hot编码。换道意图识别部分则具体提出BiLSTM-F(BiLSTM-fusion)模型,在该模型中将注意力机制(attention mechanism)引入双向长短期记忆网络(BiLSTM),对输入处理部分的输出信息进行权重划分,使模型能将注意力更加集中于对换道意图影响较大的特征信息上,最后引入条件随机场(conditional random field),充分学习输入数据的前后依赖性并快速找出全局最优的换道意图。实验中使用公开数据集NGSIM进行训练并评估,验证结果表明该模型的准确率最高能达到97.19%,并且可在车辆到达换道点前2 s识别车辆的换道意图,准确率为94.16%。与基线换道意图识别模型相比,所提出模型的准确率、损失、F1值和稳定性均优于基线模型。

Optical coherence tomography angiography of optic disc perfusion in non-arteritic anterior ischemic optic neuropathy

AIM：To compare the optic disc blood flow of non-arteritic ischemic optic neuropathy（NAION）eyes with normal eyes.METHODS：The optic disc blood flow densities of diagnosed non-acute phase NAION eyes（21 eyes,14 individuals）and normal eyes（19 eyes,12 individuals）were detected via Optovue optical coherence tomography angiography（OCTA）.The optic disc blood flow was measured via Image J software.Correlations between optic disc perfusion and visual function variables were assessed by linear regression analysis.RESULTS：The average percentage of the optic disc nonperfusion areas in the non-acute phase NAION patients（17.84%±6.18%）was increased,when compared to the normal control eyes（8.61%±1.65%）,and the difference was statistically significant（P〈0.01）.Moreover,there was a proportional correlation between the visual field mean defect（MD）and the optic disc non-perfusion area percentage,and the relationship was statistically significant（t=3.65,P〈0.01,R2=0.4118）.In addition,the critical correlation between the best corrected visual acuity（BCVA）and the optic disc non-perfusion area percentage was statistically significant（t=4.32,P〈0.01,R2=0.4957）.CONCLUSION：The optic disc non-perfusion area percentages detected via OCTA in NAION eyes were significantly increased when compared with the normal eyes.Both the BCVA and MD were correlated with the optic disc flow detected,revealing that OCTA may be valuable in the diagnosis and estimation of NAION.

Change of retinal nerve fiber layer thickness in patients with nonarteritic inflammatory anterior ischemic optic neuropathy

In this study, 16 patients （19 eyes） with nonarteritic anterior ischemic optic neuropathy in the acute stage （within 4 weeks） and resolving stage （after 12 weeks） were diagnosed by a series of complete ophthalmic examinations, including fundus examination, optical coherence tomography and fluorescein fundus angiography, and visual field defects were measured with standard automated perimetry. The contralateral uninvolved eyes were used as controls. The retinal nerve fiber layer thickness was determined by optical coherence tomography which showed that the mean retinal nerve fiber layer thickness and the retinal nerve fiber layer thickness from temporal, superior, nasal and inferior quadrants were significantly higher for all measurements in the acute stage than the corresponding normal values. In comparison, the retinal nerve fiber layer thickness from each optic disc quadrant was found to be significantly lower when measured at the resolving stages, than in the control group. Statistical analysis on the correlation between optic disc nerve fiber layer thickness and visual defects demonstrated a positive correlation in the acute stage and a negative correlation in the resolving stage. Our experimental findings indicate that optical coherence tomography is a useful diagnostic method for nonarteritic anterior ischemic optic neuropathy and can be used to evaluate the effect of treatment.

Clinical characteristics of progressive nonarteritic anterior ischemic optic neuropathy

AIM:To study whether patients with progressive nonarteritic anterior ischemic optic neuropathy(NAION)present earlier than patients with stable NAION and to describe their clinical characteristics and visual outcome.METHODS:This was a retrospective chart review.All patients with NAION seen during the acute stage from January 2012 to December 2018 were reviewed.Patients were included if they had documented disc edema and follow up of at least 3 mo.Patients with progressive NAION were identified if they worsened in 2 out of 3 parameters:visual acuity≥3 Snellen lines;Color vision≥4 Ishihara plates;the visual field defect involved a new quadrant.The clinical characteristics,time from symptom onset to presentation,systemic risk factors and visual outcome were compared to patients with stable NAION.RESULTS:Totally 122 NAION cases met the inclusion criteria.Mean age was 58.1 y(range 22-74),70%were men.Twenty cases(16.4%)had progressive NAION.Patients with progressive NAION did not differ from stable NAION in their demographics,systemic risk factors or in their initial visual deficit.At last follow up,median visual acuity was 1.0 log MAR(IQR 0.64-1.55)in patients with progressive NAION,vs 0.18(IQR 0.1-0.63)in stable NAION(P<0.001).Median color vision testing was 0 plates correct(IQR 0-2.5%)vs 92%plates correct(IQR 50%-100%)in the stable NAION group(P<0.001).Patients with progressive NAION differed in the time from symptom onset to presentation(median 2 d vs 5 d,P=0.011).CONCLUSION:We find no identifiable risk factors associated with progressive NAION.Progressors arrive earlier for ophthalmological evaluation.

Macular ganglion cell complex injury in different stages of anterior ischemic optic neuropathy

BACKGROUND Anterior ischemic optic neuropathy(AION)is a group of ophthalmic diseases in which the optic nerve is injured causing blindness.However,the pathogenesis,clinical manifestations,and clinical treatments of AION are yet elusive.Only a few related experimental or clinical reports are available on the disease.In this study,spectral domain optical coherence tomography(SD-OCT)was used to examine the morphology of thickness swelling and atrophic changes of macular ganglion cell complex(mGCC)in the different stages of AION that were then compared with the visual fields.Thus,the clinical value of mGCC examination was alleged to be similar to that of the visual field.AIM To explore the mGCC injury at different stages in AION and the clinical significance.METHODS Cases with AION were analyzed in a retrospective study.SD-OCT was used to analyze the correlation between mGCC and peripapillary retinal nerve fiber layer thicknesses at different stages of AION and the changes in the corresponding stages of visual fields.RESULTS A total of 21 cases(28 eyes)presented AION.The onset time of AION was defined as early stage(within 3 wk of onset),middle stage(from 3 wk to 2 mo),and late stage(disease span>2 mo).In the early stage,the mGCC thickness of SD-OCT was within the normal high limit,and the perioptic nerve fibers thickness was more than the normal.The changes in the visual field in early stage were not consistent with the swelling changes in mGCC and peri-disc nerve fibers.In addition,atrophy and thinning appeared in mGCC,and the perioptic nerve fibers were swollen.However,the thickness was lower in the middle period than that in the early stage.The change in visual field was consistent with that of mGCC in this period.In the late stage,mGCC shrank and thinned,and the thickness of the nerve fibers around the optic disc in the corresponding region shrank and thinned.CONCLUSION The changes in mGCC thickness in patients with AION showed early,middle,and late stages of development by SD-OCT.Although the early stage visual field changes of AION were not consistent with the swelling changes of mGCC,the horizontal delimitation or annular atrophy of mGCC was consistent with that in the middle and late stage of the disease.The atrophy of peripheral nerve fibers was later than that of the mGCC atrophy.

加味黄芪汤治疗气虚血瘀证NAION的临床研究

目的观察加味黄芪汤治疗非动脉炎性前部缺血性视神经病变(NAION)患者眼部相关参数及中医证候积分的临床疗效。方法纳入2018年1月—2021年12月就诊于北京中医药大学东方医院眼科的NAION患者63例(63只眼),证属气虚血瘀证,随机分为治疗组32例(32只眼)和对照组31例(31只眼)。对照组给予改善微循环、营养神经治疗,治疗组在对照组的基础上联合加味黄芪汤治疗,分别于治疗前和治疗后检测2组患者的最佳矫正视力(BCVA)、视野平均缺损(MD)、视网膜神经纤维层(RNFL)和神经节细胞-内丛状层复合体(GCIPL)的平均厚度及中医证候积分变化,记录数据并做统计分析。结果治疗前2组的BCVA、MD、RNFL、GCIPL的平均厚度及中医证候积分比较,均无统计学意义(P>0.05)。(1)BCVA:治疗前后比较,2组治疗后BCVA均较治疗前提高(t_(治疗组)=5.496,P=0.000;t_(对照组)=2.973,P=0.006)。治疗后2组与治疗前的差值比较,治疗组BCVA的提高幅度较对照组大(t=2.008,P=0.049),差异有统计学意义。(2)MD:治疗前后比较,2组治疗后MD均较治疗前减少(t_(治疗组)=5.220,P=0.000;t_(对照组)=3.236,P=0.002)。治疗后2组与治疗前的差值比较,治疗组MD的改善幅度较对照组大(t=2.224,P=0.030),差异有统计学意义。(3)RNFL、GCIPL的平均厚度:治疗前后比较,2组治疗后RNFL均较治疗前降低(t_(治疗组)=5.639,t_(对照组)=5.689,均P=0.000);2组治疗后GCIPL亦较治疗前降低(t_(治疗组)=2.931,P=0.005;t_(对照组)=4.445,P=0.000),差异均有统计学意义。治疗后2组与治疗前的差值比较,RNFL和GCIPL差异均无统计学意义(P>0.05)。(4)中医证候积分:治疗前后比较,2组治疗后中医证候积分均较治疗前降低(t_(治疗组)=8.646,t_(对照组)=5.906,均P=0.000)。治疗后2组间比较,治疗组中医证候积分较对照组降低(t=2.972,P=0.004),差异均有统计学意义。(5)临床疗效:治疗组总有效率(84.38%)高于对照组(58.06%),差异有统计学意义(χ^(2)=5.341,P=0.021)。结论加味黄芪汤能提高NAION患者的BCVA,降低视野MD水平,对于患者视功能的恢复有一定作用。

青光眼常用检查设备规范操作指南(2023)

青光眼是一种进行性视神经病变,也是位列首位的不可逆致盲性眼病,尽早明确诊断对于该病的防治至关重要。规范青光眼常用检查设备的操作可以提高青光眼检查结果的准确性,有助于眼科医生,尤其青光眼专科医生,更好地掌握青光眼常用检查方法,减少青光眼患者的误诊和漏诊,对青光眼的防治具有重要意义。本指南总结了青光眼的常用检查设备的规范操作,为规范青光眼的常用检查方法、提高基层医疗青光眼诊断效能提供参考指南。

垂体卒中患者的临床特点和治疗效果观察:1项单中心回顾性研究

目的:探讨垂体卒中(pituitary apoplexy,PA)患者的症状、内分泌和影像学特点、临床转归及预后。方法:回顾性分析四川大学华西医院2015年1月1日—2021年12月31日期间诊断为“垂体卒中”患者资料。PA的诊断基于临床、影像学和病理组织学报告。总结其临床症状和体征、神经影像学、病理学和内分泌学结果,并分析临床转归及预后。结果:一共46名PA患者,其中20名男性(43.5%),平均年龄为47.05(15.81)岁,女性26名,平均年龄为31.96(14.78)岁。大多数人出现头痛(n=38,82.6%)和不同程度激素缺乏,其中最常见的垂体-性腺轴受累(28例,60.9%),其次是垂体-甲状腺轴受累(21例,45.7%);垂体-肾上腺轴受累(19例,41.3%);生长激素(growth hormone,GH)/胰岛素样生长因子-1(insulin-like growth factor 1,IGF-1)轴受累5例(10.9%);垂体后叶受累(尿崩症)8例(17.4%)。所有垂体卒中患者都有核磁共振成像(magnetic resonance imaging,MRI)上的特征性改变,部分卒中患者的垂体MRI存在典型的液平。9例(19.6%)接受抗血栓治疗,12例接受手术治疗的患者随访中的7例存在垂体腺瘤复发,但无患者在急性病程中死亡。在随访期间(5.2±1.9)年,大部分患者存在垂体-靶腺激素低下,均予以激素替代治疗。结论:PA属于神经内分泌危急重症,症状早期认识和及时治疗,尤其是内分泌紊乱的纠正对于避免严重并发症至关重要。临床医师需要重视PA的垂体前叶功能减退,以避免潜在的风险。

Corticostriatal Neurons in the Anterior Auditory Field Regulate Frequency Discrimination Behavior

The anterior auditory field(AAF)is a core region of the auditory cortex and plays a vital role in discrimination tasks.However,the role of the AAF corticostriatal neurons in frequency discrimination remains unclear.Here,we used c-Fos staining,fiber photometry recording,and pharmacogenetic manipulation to investigate the function of the AAF corticostriatal neurons in a frequency discrimination task.c-Fos staining and fiber photometry recording revealed that the activity of AAF pyramidal neurons was significantly elevated during the frequency discrimination task.Pharmacogenetic inhibition of AAF pyramidal neurons significantly impaired frequency discrimination.In addition,histological results revealed that AAF pyramidal neurons send strong projections to the striatum.Moreover,pharmacogenetic suppression of the striatal projections from pyramidal neurons in the AAF significantly disrupted the frequency discrimination.Collectively,our findings show that AAF pyramidal neurons,particularly the AAF–striatum projections,play a crucial role in frequency discrimination behavior.

非动脉炎性前部缺血性视神经病变伴黄斑区浆液性神经上皮脱离临床特点及治疗

目的探讨非动脉炎性前部缺血性视神经病变(NAION)伴发黄斑区浆液性神经上皮脱离(MSND)与不伴发黄斑区浆液性神经上皮脱离主要临床特征与治疗预后的区别。方法选取NAION患者76例77只眼进行研究,分为MSND组和非MSND组,两组进行一般情况(年龄、性别、眼别、高血压、糖尿病、高脂血症、吸烟史)、眼压、最佳矫正视力、视野缺损值及治疗后最佳矫正视力、视野缺损值比较。结果MSND组与非MSND组在发病初诊时一般情况、眼压、最佳矫正视力、视野缺损值均未见明显统计学差异,两组均使用同一综合治疗法治疗30天后,两组最佳矫正视力、视野缺损值均较治疗前有效改善,差异有统计学意义,两组间最佳矫正视力、视野缺损治疗有效值均未见明显统计学差异。结论NAION伴发MSND与未发生MSND患者之间一般情况无明显统计学差异;NAION患者是否伴发MSND不影响预后;综合治疗可有效改善非动脉炎性前部缺血性视神经病变患者最佳矫正视力、降低视野缺损值。

田径教学中本体感觉训练干预学生前交叉韧带损伤风险的实验研究

前交叉韧带损伤是田径运动中较为多见的一类损伤,也是跳高、跳远等田径项目教学训练中需要重点关注的损伤类型。因此,该文尝试将本体感觉训练作为干预手段引入田径教学之中,并借助对照实验检验其在教学中对学生前交叉韧带损伤风险产生的影响。结果表明:经过12周的教学实验后,实验班学生在膝关节控制能力、骨盆控制能力、动作对称性以及着地质量4个维度上的得分都要高于控制班,且两班各维度的测试数据均有了显著性差异(P<0.05)。说明实验班学生的团身跳跃测试表现要显著优于控制班,其前交叉韧带损伤风险要显著低于控制班,从而证实了田径教学中本体感觉训练在降低学生前交叉韧带损伤风险方面的积极作用。

前房穿刺在管状视野青光眼滤过手术中的应用

目的:探讨前房穿刺在管状视野青光眼滤过手术中避免发生并发症的有效性。方法:42例(42眼)管状视野青光眼患者在表面麻醉下行滤过手术,术中通过前房穿刺缓慢放出房水,防止视力丧失,术后5～7d复查视野、眼压。结果:42例手术无1例丧失残存视功能,视力维持术前或有所提高,视野有改善,眼压控制良好。结论:本研究证实采用前房穿刺技术在管状视野青光眼滤过手术中对于避免出现视力丧失是一种安全有效的方法。

垂体前叶内神经纤维可能参与ACTH分泌的调节

我们建立了垂体组织块短时温育并施加电场刺激的离体实验体系，运用此方法并结合放射免疫测定激素含量，观察了大鼠垂体前叶内神经纤维对促肾上腺皮质激素（ＡＣＴＨ）释放的影响。结果表明，电场刺激能够促使垂体前叶ＡＣＴＨ释放显著增加，刺激参数为强度３０ｍＡ，波宽０．５ｍｓ，频率１０Ｈｚ。这个效应可为温育液中加入河豚毒素（ＴＴＸ）和藜芦碱所阻断，但ＴＴＸ不能阻断精氨酸加压素（ＡＶＰ）诱发的ＡＣＴＨ分泌。同样参数的电场刺激对分散培养的大鼠垂体前叶细胞ＡＣＴＨ的分泌没有显著作用。以上结果说明，我们所用参数的电场刺激产生的效应是兴奋了垂体前叶内的神经纤维，而非直接刺激腺细胞所致。上述结果提示：垂体前叶激素分泌的调节除了传统的体液途径之外，还可能存在直接的神经控制。

非动脉炎性前段缺血性视神经病变和特发性视神经炎视野改变的比较研究

目的比较非动脉炎性前段缺血性视神经病变(NAION)和特发性视神经炎(ION)患者的视野变化特点,分析其发生机制。方法收集2012年3月至2013年10月期间在中国医科大学附属第四医院眼科诊治的NAION和ION患者的视野资料,比较患者的年龄、性别组成、视力、瞳孔直径、视野检测时间、视野缺损特点、视野平均缺损(MD)和模式缺损(PSD)情况。结果ION患者48例67只眼、NAION患者48例54只眼,2组患者平均年龄、性别比例、视力、瞳孔直径、视野检测时间、视野MD和PSD等的差异具有统计学意义(P<0.05)。结论 NAION和ION患者的视野表现复杂多样,各具特点,与其发病机制密切相关。

非动脉炎性前部缺血性视神经病变的电生理及临床特征分析

目的研究非动脉炎性前部缺血性视神经病变(NAION)的电生理及临床特征。方法收集2013年3月至2014年3月我院确诊为NAION的17例患者28眼,分析其图形视觉诱发电位(PVEP)、荧光素眼底血管造影(FFA)、视野(VF)等临床检查特征。结果 28眼均行PVEP检查,其中21眼P100波幅值在1°或15'空间频率均出现不同程度降低。P100波峰时在1°空间频率5眼中度延迟(>15 ms),其余23眼未见明显延迟或者轻度延迟;15'空间频率时6眼中度延迟(>15 ms),其余22眼峰时未见明显延迟或者轻度延迟(<15 ms)。15患者23眼行FFA检查,其中6患者(40%)患者臂-视网膜循环时间(ART)大于15 s。7眼后期出现高荧光,其余后期呈低荧光。28眼均行视野检查,其中10眼正常,7眼视敏度降低或暗点(4眼集中在生理盲点附近),7眼呈现与生理盲点相连的缺损,4眼残存部分视野。对比分析PVEP和FFA,发现FFA后期高荧光的患眼P100波峰时呈中度以上延迟,后期低荧光患眼的峰时未见明显延迟或轻度延迟。对比分析PVEP和视野,发现14眼VF和PVEP均异常,7眼视野正常时PVEP异常,4眼PVEP正常时而VF异常。结论 NAION的PVEP的P100波峰时大多为正常或轻度延迟,当视乳头水肿、FFA后期视盘高荧光时P100波峰时明显延迟。FFA的ART延长不是NAION的敏感指标。PVEP对于视野正常的患眼有辅助诊断的价值。

视神经炎和前段缺血性视神经病变及视乳头水肿的视野改变分析

目的:比较特发性脱髓鞘性视神经炎(idiopathic demyelinating optic neuritis,IDON)、非动脉炎性前段缺血性视神经病变(non-arteritic anterior ischemic optic neuropathy,NAION)和视乳头水肿(papilledema,PE)患者的视野变化特点,分析其发生机制。方法:回顾性病例研究。收集2011-03/2012-05期间在中国医科大学附属第四医院眼科诊治的IDON,NAION和PE患者的视野资料,记录患者的年龄、性别组成、最佳矫正视力(BCVA)、瞳孔大小、完成视野检测的时间、视野缺损的类型、部位、平均缺损(MD)和模式缺损(PSD)情况,SPSS 12.0统计软件包比较三组患者之间的差异。结果:IDON患者17例20眼,NAION患者21例26眼,PE患者11例22眼。三组患者平均年龄、性别比例、BCVA、瞳孔大小、完成视野检测的时间、视野MD和PSD的差异均具有统计学意义(P<0.05)。结论:IDON,NAION和PE患者的视野表现复杂多样,但又各有特点,这与三种疾病的发病机制密切相关,为视神经疾病的鉴别诊断提供依据。

活血通络颗粒治疗前部缺血性视神经病变的临床观察

目的观察活血通络颗粒治疗前部缺血性视神经病变的临床疗效。方法将60例(60只眼)前部缺血性视神经病变患者分为治疗组30例(30只眼)、对照组30例(30只眼)。对照组予常规治疗,包括静脉滴注丹参注射液,患眼使用噻吗洛尔滴眼液,球后注射地塞米松+盐酸消旋山莨菪碱注射液+2%利多卡因注射液,口服维生素B1、腺苷辅酶B12,并对症治疗高血压、高血脂等疾病。治疗组予常规治疗,并口服活血通络颗粒。对治疗后的临床疗效、视力、视野的平均光敏感度进行统计分析。结果治疗组临床显效21例(21只眼),有效8例(8只眼),总有效率96.70%;对照组临床显效14例(14只眼),有效9例(9只眼),总有效率76.67%,2组差异有统计学意义(P<0.05)。2组治疗前后视力分布、视野平均光敏感度比较,差异有统计学意义(P<0.05)。结论活血通络颗粒能够提高前部缺血性视神经病变患者的视力,并改善视野。

三维适形放射治疗技术治疗复发性宫颈癌的短期疗效评估

目的探讨三维适形放射治疗技术(3-dimensional conformal radiotherapy,3D-CRT)对复发性宫颈癌的临床疗效。方法收集我院2004年4月至2007年12月间实施三维适形放疗及同步化疗的复发性宫颈癌病例共42例作为观察组,并以同期采用盆腔前后野照射及同步化疗的复发性宫颈癌病例共34例作为对照组。判断2组治疗疗效和急性放射毒副反应。结果观察组完成外照射肿瘤处方剂量(DT)(45.0±7.3)Gy,对照组完成外照射肿瘤处方剂量(37.0±4.5)Gy,2组之间没有统计学差异(P>0.05);观察组局部控制率52.38%(22/42),对照组为32.35%(11/34),两组间有统计学差异(P<0.05);通过生存曲线分析,观察组中位生存时间18.13个月,显著高于对照组的12.53个月(P<0.01);观察组1例发生膀胱阴道瘘,2例出现直肠阴道瘘,12例出现Ⅲ度以上骨髓抑制。对照组8例出现Ⅲ度以上骨髓抑制,2例发生膀胱阴道瘘。结论三维适形放疗技术用于复发性宫颈癌的治疗的疗效优于盆腔前后野照射,不增加放射副反应。