復方樟柳堿兩種注射方法治療視網膜中央靜脈阻塞的比較

[摘要] 目的 比較顳淺動脈旁皮下注射和球后注射復方樟柳堿治療視網膜中央靜脈阻塞的臨床效果和護理措施。方法 方便選取2015 年1月—2016年6月該院眼科門診確診的73例缺血性視網膜中央靜脈阻塞患者在激光治療的同時應用復方樟柳堿輔助治療，按隨機數字表分為2組，36例采用顳淺動脈旁皮下注射，37例采用球后注射。對兩組的病例作視力、FFA檢查、注射NRS評分、不良反應的對比。 結果 治療后顳淺動脈旁皮下注射組NRS評分較球后注射組低，比較差異有統計學意義（P<0.05），球后注射組治療后少數的患者出現眼球活動受限、暫時性上瞼下垂、一過性瞳孔散大等改變，皮下注射組未出現不良反應。兩組視力及FFA檢查差異無統計學意義（P>0.05）。 結論 顳淺動脈皮下注射復方樟柳堿治療缺血性視網膜中央靜脈阻塞，與球后注射給藥有相當的療效，且患者的疼痛程度低，不良反應較少。

[關鍵詞] 復方樟柳堿；視網膜中央靜脈阻塞；皮下；顳淺動脈

[中圖分類號] R473 [文獻標識碼] A [文章編號] 1674-0742（2016）10（b）-0143-04

[Abstract] Objective Comparison of clinical effect and nursing experience was injected subcutaneously around superficial temporal artery and retrobulbar injection of compound anisodine in the treatment of central retinal vein occlusion. Methods Convenient selection January 2015 to June 2016 in our hospital outpatient diagnosis of 73 cases of ischemic central retinal vein obstruction patients in laser treatment and application of compound anisodine adjuvant therapy， according to the random number table is divided into 2 groups and 36 patients with para temporal superficial artery subcutaneous injection， 37 cases with retrobulbar injection. Visual acuity， FFA examination， NRS score and adverse reaction were compared between the two groups. Results After treatment， numeric rating scales of the patients with Compound Anisodine subcutaneous injection near the temporal superficial artery were significantly lower than the retrobulbar injection group（P<0.05）. Moreover some of the eyes after conduct of retrobulbar injection show the signs as limitation of motion 、blephroptosis and mydriasis. while patients of subcutaneous injection group appear no adverse reaction. The visual acuity and FFA of subcutaneous injection group and retrobulbar injection group have no statistics difference （P>0.05）. Conclusion Subcutaneous Injection near the temporal superficial artery with Compound Anisodine has the same therapeutic effect as retrobulbar injection on CRVO， though with lower pain degree and the fewer side reactions.

[Key words] Compound anisodine；Central retinal vein occlusion； Subcutaneous ； Temporal superficial artery

視網膜中央靜脈阻塞（central retinal vein occlusion，CRVO） 是眼科多見的嚴重視網膜血管性疾病，患病率在30歲以上的患者占0.3%～0.5%。CRVO以視網膜靜脈迂曲擴張、出血、水腫滲出為特點，視力損害主要取決于阻塞與黃斑水腫的程度[1]。樟柳堿是從茄科植物唐古特山莨菪中分離出來的一種生物堿，作用機制與阿托品類藥物相似，其復方制劑具有減輕眼血管痙攣和改善血管舒縮的功能[2]。該院于2015 年1月—2016年6月近四年來到該院眼科門診確診的患者73例為研究對象，分別應用顳淺動脈旁注射和球后注射復方樟柳堿治療缺血性視網膜中央靜脈阻塞，并且比較兩種方法的輔助激光治療的效果，現報道如下?！?br>