硝酸甘油泵入治疗视网膜中央动脉阻塞的临床观察

目的研究硝酸甘油泵入治疗视网膜中央动脉阻塞(CRAO)的有效性。方法32例(32眼)确诊为视网膜中央动脉阻塞患者,随机分为微泵组及对照组,每组16例(16眼)。对照组患者给予舌下含服硝酸甘油片联合常规治疗,微泵组患者给予静脉泵入硝酸甘油联合常规治疗。比较两组患者治疗后最佳矫正视力、视网膜水肿发生情况及治疗前后臂-视网膜循环时间。结果治疗后,微泵组患者最佳矫正视力为(0.35±0.11),对照组患者最佳矫正视力为(0.16±0.07),微泵组患者治疗后最佳矫正视力优于对照组,差异具有统计学意义(P<0.05)。治疗后,微泵组患者的视网膜水肿发生率为31.25%(5/16),明显低于对照组的68.75%(11/16),差异具有统计学意义(P<0.05)。微泵组患者治疗前臂-视网膜循环时间为(38.7±2.4)s,治疗1周后臂-视网膜循环时间为(20.4±2.3)s;对照组患者治疗前臂-视网膜循环时间为(36.9±3.5)s,治疗1周后臂-视网膜循环时间为(29.3±3.1)s;两组患者治疗前臂-视网膜循环时间比较,差异无统计学意义(P>0.05);治疗1周后,两组患者的臂-视网膜循环时间均短于治疗前,且微泵组短于对照组,差异具有统计学意义(P<0.05)。结论硝酸甘油泵入治疗视网膜中央动脉阻塞效果显著,可有提高患者的视力,促进视网膜血液循环的恢复。

Clinical observation on nitroglycerin pumping for central retinal artery occlusion

Objective To study the effectiveness of nitroglycerin pumping for central retinal artery occlusion(CRAO).Methods A total of 32 cases(32 eyes)with central retinal artery occlusion were randomly divided into micro pump group and control group,with 16 cases(16 eyes)in each group.The control group received sublingual nitroglycerin tablets combined with conventional treatment,and micro pump group received nitroglycerin pumping combined with conventional treatment.The best corrected visual acuity after treatment,the occurrence of retinal edema and the time of arm-retina circulation time before and after treatment were compared between the two groups.Results After treatment,the best corrected visual acuity was(0.35±0.11)in micro pump group,which was(0.16±0.07)in the control group.After treatment,the best corrected visual acuity in the micro pump group was better than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the incidence of retinal edema was 31.25%(5/16)in micro pump group,which was obviously lower than 68.75%(11/16)in the control group,and the difference was statistically significant(P<0.05).In micro pump group,the arm-retina circulation time was(38.7±2.4)s before treatment,and(20.4±2.3)s after 1 week of treatment.In the control group,the arm-retina circulation time was(36.9±3.5)s before treatment,and(29.3±3.1)s after 1 week of treatment.Before treatment,there was no statistically significant difference in arm-retina circulation time between the two groups(P>0.05).After 1 week of treatment,the arm-retina circulation time in the two groups was shorter than those before treatment,and the micro pump group was shorter than the control group.Their difference was statistically significant(P<0.05).Conclusion Nitroglycerin pumping shows significant effect for the treatment of central retinal artery occlusion,and it can improve the vision of patients and promote the recovery of retinal blood circulation.