鼻咽癌放疗所致眼部损伤的临床研究

目的　对鼻咽癌患者在放疗中所造成的眼部损害进行临床评估，寻找减轻损害程度的干预措施，尽最大可能提高鼻咽癌患者的生活质量。方法　在调强放疗条件下，所有５０例患者在放疗方案设计时均最大限度地考虑降低眼部及视神经的Ｘ线受量。试验组２５例，在放疗期间给予复方丹参注射液、肌苷、辅酶Ａ和维生素Ｂ２治疗；对照组２５例，仅给予放射治疗。结果　对照组与试验组放疗前裸眼视力、矫正视力、屈光度数、眼压、黄斑中心凹厚度和视网膜微血管瘤阳性的差异均无统计学意义（Ｐ＞０.０５），对照组与试验组放疗后上述指标中黄斑中心凹厚度、视网膜微血管瘤阳性的差异有统计学意义（Ｐ＜０.０５）。结论　放疗可引起患者视网膜水肿和视网膜微血管瘤，对患者视力、眼屈光变化及眼压无明显影响；放疗中预防性使用复方丹参注射液、肌苷、辅酶Ａ和维生素Ｂ２对患者视网膜水肿和视网膜微血管瘤的防治可能具有一定效果。

Clinical study of eye injury of nasopharyngeal carcinoma patients caused by radiotherapy

Objective To evaluate the eye damage of nasopharyngeal carcinoma patients caused by radiotherapy,to find interventions to reduce the extent of damage,and to maximize possible extent to improve the quality of life in patients with nasopharyngeal carcinoma.Methods In IMRT conditions,all 50 patients in the radiotherapy plan were designed to minimize the X-ray volume to eyes and optic nerves.In treatment group,25 patients were administrated by IMRT combined with compound Danshen injection,inosine,coenzyme A and vitamin B2.Twenty-five patients in control group were treated by IMRT only.Results Visual acuty,intraocular pressure,corrected visual acuity and diopters between the two groups didn＇t show statistical significance（P0.05）,while foveal thickness and positive retinal capillany hemangioma in control group were higher than those in treatment group with statistical significance（P0.05）.Conclusion Radiotherapy may cause retinal edema and retiral capillany hemangiowa,but would not impact visual acuity,refractive and intraocular pressure.The appliance of compound Danshen injection,inosire,coenzyme A and vitamin B2 may prevent and treat retinal edema and retinal capillary hemangioma caused by radiotherapy.