球后注射曲安奈德治疗黄斑水肿对老年患者血糖水平的影响

目的糖皮质激素是所有药物中对血糖影响最大的药物,观察球后注射曲安奈德治疗老年人糖尿病性及非糖尿病性黄斑水肿(DME)对血糖的影响。方法选取北京老年医院眼科≥65岁DME患者80例,分为糖尿病组和非糖尿病组,每组40例,40只眼,给予患眼球后注射曲安奈德20 mg治疗。监测患者给药前、治疗后连续7 d及治疗后14 d的空腹血糖和餐后2小时血糖。采用SPSS 17.0统计软件进行分析。组内比较采用方差分析,组间比较采用独立样本t检验。结果非糖尿病组患者的空腹血糖[(5.35±0.33)mmol/L]、餐后2小时血糖[(7.66±0.34)mmol/L]及糖尿病组患者的空腹血糖[(8.53±0.59)mmol/L]在第2天升为最高,糖尿病组患者的餐后2小时血糖[(13.32±2.70)mmol/L]在第3天升至最高。非糖尿病组在治疗后第4、5、6、7及14天的血糖水平和治疗前比较,差异无统计学意义,而糖尿病组在注射的第14天血糖升高相比治疗前,差异仍有统计学意义(P0.05)。糖尿病组较非糖尿病组的空腹血糖最大差值[(0.65±0.21)vs(2.91±0.27)mmol/L]和餐后2小时血糖最大差值[(1.10±0.37)vs(4.59±2.15)mmol/L]均显著增加(P0.01)。结论球后注射曲安奈德可引起血糖升高,升高峰值出现在注射后第2天或第3天,且对糖尿病患者影响更明显。眼科医师应对此类药物的副作用给予关注。     

曲安奈德球内注射治疗黄斑水肿效果观察（附25例报告）

目的观察曲安奈德球内注射治疗黄斑水肿的效果。方法50例黄斑水肿患者随机分为常规组（常规药物治疗＋激光治疗）和观察组（曲安奈德球内注射治疗）,各25例。比较两组视力、黄斑厚度、治愈率。结果观察组治疗后视力为0．66±0．21、黄斑中央厚度（320±63）μm,治愈率为92％;常规组分别为0．45±0．06、（400±21）μm和72％（P均〈0．05）。结论与常规治疗比较,曲安奈德球内注射治疗黄斑水肿疗效可靠。     

曲安奈德联合地塞米松球后注射治疗中度甲亢突眼213例疗效观察

约50％的甲亢患者会出现突眼症状，常伴有眼睑退缩、眼睑结膜充血水肿等软组织受累以及复视、眼球活动受限等眼外肌受累症状，可引起暴露性角膜炎、角膜溃疡、视力下降及视野缺损。2007年1月～2010年10月，我们对213例甲亢突眼患者采用曲安奈德联合地塞米松球后注射，取得较好效果。现报告如下。     

曲安奈德球后注射联合卵磷脂络合碘口服治疗黄斑水肿疗效观察

目的 观察曲安奈德(TA)球后注射联合卵磷脂络合碘口服治疗黄斑水肿的疗效.方法 黄斑水肿患者42例54眼,27眼(观察组)球后注射TA联合口服卵磷脂络合碘,27眼(对照组)单纯球后注射TA,随访6个月.结果 最终随访时观察组视力提高19眼、水肿减轻20眼、水肿复发2眼,对照组分别为15、17、8眼,两组治疗后视力提高和水肿减轻相比,P均＞0.05,水肿复发相比,P＜0.05.结论 TA球后注射联合卵磷脂络合碘口服可有效治疗黄斑水肿,并减少复发.     

曲安奈德皮损内注射联合放疗治疗瘢痕疙瘩的疗效观察

目的观察曲安奈德皮损内注射联合放疗治疗瘢痕疙瘩的临床疗效。方法将60例瘢痕疙瘩患者随机分为两组,A组采用曲安奈德40~80 mg皮损内注射,每4周1次,至瘢痕疙瘩变软、变平;最后一次注射后1周内行局部6 M eV电子线外照射,共1 600~2 000 cGy;B组行单纯曲安奈德皮损内注射,方法同A组,瘢痕疙瘩变平、变软后加强1次。结果 A、B组总有效率分别为87.23%、79.59%,治愈率分别为55.32%、34.69%,两组治愈率比较有统计学差异（P〈0.05）。结论曲安奈德皮损内注射联合放疗治疗瘢痕疙瘩疗效确切,其疗效优于单纯曲安奈德皮损内注射治疗。     

玻璃体腔内注射曲安奈德治疗黄斑水肿并发症的临床分析

目的探讨玻璃体腔内注射曲安奈德(TA)治疗黄斑水肿后出现的各种并发症的发病率及特点。方法回顾性收集经眼底、萤光素眼底血管造影(FFA)及光学相干断层扫描(OCT)检查诊断为视网膜静脉阻塞所致的黄斑水肿并接受玻璃体腔内注射TA的37例老年及37例中年患者的临床资料,统计术后各类并发症的发病率。结果(1)老年组术后发生高眼压,非感染性眼内炎,结膜溃疡及黄斑裂孔者明显多于中年组。房水闪辉,赋形剂残留在两组中发病率无明显差异。结论TA玻璃体腔内注射更适合治疗视网膜静脉阻塞所致的老年性黄斑水肿。     

眼玻璃体腔内注射曲安奈德治疗黄斑水肿效果观察

视网膜静脉阻塞(RVO)可导致黄斑水肿,糖尿病视网膜病变(DR)也能导致黄斑水肿,随水肿时间延长,最终导致病人视力丧失[1].目前,临床上对黄斑水肿的治疗方法主要是应用激素.有文献报道,曲安奈德(TA)是一种长效糖皮质激素,治疗各种眼部炎症及黄斑水肿效果明显且副作用较少[2].黑龙江省医院眼科2007年6月以来对RVO、DR引起黄斑水肿的患者应用TA玻璃体腔注射,结果报道如下.     

曲安奈德在玻璃体手术及治疗黄斑区水肿中的应用

曲安奈德注射液(TA)可用于治疗多种原因引起的黄斑水肿,减少眼内新生血管的形成,抑制增殖性视网膜脱离病变发生,在严重葡萄膜炎、视网膜坏死、外伤眼内炎等疾病治疗中取得较理想效果[1].我院近年来采用玻璃体腔注射TA,观察其在玻璃体手术中协助辨别和清除残留玻璃体皮质的作用.     

内镜下扩张联合黏膜下注射曲安奈德在食管良性狭窄治疗中的应用价值研究

目的探讨内镜下扩张联合黏膜下注射曲安奈德治疗食管良性狭窄的安全性及其应用价值。方法69例患者随机分为3组,分别接受单纯内镜下扩张治疗（A组）、内镜下扩张联合单次注射注射曲安奈德治疗（B组）和内镜下扩张联合多频次注射注射曲安奈德治疗（C组）。比较3组并发症发生情况、治愈率、持续症状缓解时间、再次行内镜下扩张治疗的间隔时间、内镜治疗结束后Stooler分级评分。结果术后部分患者出现胸痛及反流症状,均经对症治疗后症状改善,未出现严重出血、感染、穿孔及局部组织萎缩坏死等并发症。内镜治疗结束后3组Stooler分级评分均较术前有明显改善（P〈0．05）,各组间比较差异无统计学意义（P〉0．05）。随访至52周,A组平均持续症状缓解时间及再次行内镜下扩张治疗的间隔时间分别为（14．4±3．2）周和（18．2±3．7）周,B组分别为（19．3±3．9）周和（24．6±4．2）周,C组分别为（20．2±4．2）周和（26．1±4．5）周,B组和C组均明显长于A组（P〈0．05）,B、C组问差异无统计学意义（P〉0．05）;A组治愈率为29．2％（7／24）,B组为27．3％（6／22）,C组为43．5％（10／23）,C组明显高于A组和B组（P〈0．05）,A、B组间差异无统计学意义（P〉0．05）。结论食管良性狭窄采取内镜下扩张联合黏膜下注射曲安奈德治疗是安全的,多频次注射可明显提高治愈率。     

透明质酸、曲安奈德关节腔内注射及双氯芬酸口服治疗膝骨关节炎对比观察

2005年7月-2007年7月,我们分别采用透明质酸、曲安奈德关节腔内注射及双氯芬酸口服治疗膝骨关节炎各30例,并进行了对比观察。现报告如下。     

局部注射曲安奈德结合常规介入方法治疗难治性良性中央气道狭窄疗效及安全性的初步探讨

[目的]初步探讨在狭窄部位局部注射曲安奈德治疗难治性中央气道狭窄的疗效和安全性.[方法]2008年1月至2010年12月广州医学院第一附属医院就诊的难治性良性中央气道狭窄患者20例,其中男10例,女10例,年龄(40±16)岁,给予常规介入方法结合局部注射曲安奈德治疗;同期纳入常规介入方法治疗的20例难治性气道狭窄患者作为对照,其中男7例,女13例,年龄(36±17)岁.比较2组患者的疗效和安全性,随访6～18个月观察远期疗效.[结果]2组患者治疗后气道直径、横截面狭窄率、气促指数均明显改善,两组近期疗效没有明显区别(P＞0.05);曲安奈德治疗组再狭窄的治疗间隔时间由术前的(11±5)d增加到术后的(99±56)d,20例中16例病情稳定,4例发生再狭窄需再次治疗.对照组再狭窄的治疗间隔时间为(11±4)d,两组比较差异有统计学意义(P＜0.01).治疗组治疗前后血浆皮质醇及空腹血糖水平均在正常范围,无明显波动,未出现糖皮质激素局部注射的相关并发症.[结论]局部注射曲安奈德联合常规呼吸介入方法,可明显延长难治性良性中央气道狭窄再狭窄的时间,安全性较高.     

他扎罗汀乳膏联合曲安奈德局部封闭治疗结节性痒疹的临床观察

目的观察o．1％他扎罗汀乳膏联合曲安奈德注射液局部封闭治疗结节性痒疹的临床疗效。方法168例结节性痒疹病例中,治疗组98例使用o．1％他扎罗汀乳膏联合曲安奈德注射液局部封闭治疗,对照组70例仅给予封闭治疗,共8周。对治疗前后皮损的数量及患者主观症状进行统计,比较治疗效果并分析复发情况及不良反应。结果治疗后第4周末及第8周末,治疗组有效率分别为46．9％和84．7％,对照组分别为18．6％和54．3％,差异有统计学意义（P〈o．01）。治疗后第12周复诊,治疗组复发率为5．1％,对照组为18．6％,差异有统计学意义（P〈o．01）。治疗组不良反应轻微,可以耐受。结论0．1％他扎罗汀乳膏联合曲安奈德注射液局部封闭治疗结节性痒疹疗效较好,复发率低,不良反应轻微。     

Adrenocortical function and responsiveness to tetracosactrin infusions after intra-articular treatment with triamcinolone acetonide and hydrocortisone acetate

Summary The urinary free cortisol (UFC) output, considered a parameter of the action of the exogenous corticosteroid on the hypothalamo-pituitary axis, was followed in five patients who received a total of 12 intra-articular (i.a.) injections of 40 mg of triamcinolone acetonide (TCA) distributed over eight treatment sessions. The effect of intra-articular TCA injections on UFC output was null after three treatment sessions, transient (48 hr) after another three, and more prolonged (6 days), although slight, after the remaining two sessions. These results contrast with the lasting and profound inhibition of the UFC output induced either by the same TCA dose given intramuscularly, or by oral administration of dexamethasone to 30 normal subjects, 0.75 mg at 8-hourly periods for 48 hours.Adrenocortical reactivity, as measured by the response to synthetic ACTH (tetracosactrin) of both plasma cortisol levels and UFC output, was studied in another five patients prior to and after eight i.a. injections of 40 mg of TCA, and in three patients after six i.a. injections of 25–100 mg of hydrocortisone acetate. No decrease was observed after the i.a. injections of HCA. Considered as a group the response to tetracosactrin after TCA injections was not significantly altered. Two patients showed a decreased response of both UFC and plasma cortisol, although their values remained within the limits of those obtained in 44 normal control subjects. In contrast, profound inhibition of the tetracosactrin induced response occurred in a control group of 30 sujects given 0.75 mg of dexamethasone orally at 8-hourly periods for 48 hours.     

Transanally injected triamcinolone acetonide in levator syndrome

PURPOSE: Several treatments are used for the treatment of levator syndrome, such as rectal massage, biofeedback, and galvanic stimulation. But their effects are inconsistent, and multiple treatment sessions are usually required. Triamcinolone acetonide and lidocaine mixture was injected locally into the tenderest point in levator syndrome under the hypothesis that levator syndrome is caused by tendinitis of pelvic floor musculature. METHODS: A mixture of 40 mg of triamcinolone acetonide and 1 ml of 2 percent lidocaine was injected into the tenderest point transanally in 104 patients (33 males; mean age, 51 years) with levator syndrome from December 1996 to May 1998 at Daehang Clinic. Additional injections were repeated at two-week intervals to a maximum of three injections in cases of poor response. Follow-up was performed prospectively concerning patient's perception of pain level using a visual analog scale. Depending on the response, the patients were classified into four groups: pain-free, good, fair, and no response. More than 50 percent pain reduction was classified as good, and less than 49 percent reduction as fair. RESULTS: The injection regions, where the tenderest points were identified on digital rectal compression, were left anterior anal canal in 71.2 percent of patients, right anterior in 3.8 percent of patients, and posterior in 25 percent of patients. The results of treatment were as follows: at three months after injection, response was classified as pain-free in 36.8 percent of patients, good in 35 percent of patients, fair in 19.5 percent of patients, and no response in 8.7 percent of patients; at six months the response was pain-free in 30.1 percent of patients, good in 46.5 percent of patients, fair in 18.2 percent of patients, and no response in 5.2 percent of patients. Most patients, except 8.7 percent at three months and 5.2 percent at six months, experienced treatment benefits. There were no complications during the follow-up periods. CONCLUSION: Transanal injection of triamcinolone acetonide and lidocaine mixture into the tenderest point is such a simple, safe, and very effective modality that it can be recommended as a primary therapy for levator syndrome.Read at The American Society of Colon and Rectal Surgeons' 100th Anniversary and Tripartite Meeting, Washington, D.C., May 1 to 6, 1999.     

The combination therapy of subtenon triamcinolone acetonide injection and intravitreal brolucizumab for brolucizumab-related intraocular inflammation

Rationale:Brolucizumab is a novel anti-vascular endothelial growth factor agent with clinical trials demonstrating excellent efficacy for neovascular age-related macular degeneration (AMD) in both visual and anatomic outcomes. However, there is concern of intraocular inflammation (IOI), and we propose concurrent subtenon triamcinolone acetonide (STTA) to prevent IOI.Patient concern:A 73-year-old man was treated with aflibercept for neovascular AMD in his right eye. Despite 11 months of monthly intravitreal aflibercept injections, optical coherence tomography demonstrated persistent exudation. Ten days following his second brolucizumab injection, the patient presented with decreased vision due to vitritis in his right eyeDiagnosis:Brolucizumab-related IOI in neovascular AMD refractory to aflibercept.Interventions:A combination therapy involving of intravitreal brolucizumab and STTAOutcomes:The anti-vascular endothelial growth factor inhibitor was changed back to aflibercept; however, exudation persisted. Therefore, a combination therapy involving STTA (5 mg/0.5 mL) and intravitreal injection of brolucizumab (6.0 mg/0.05 mL) was performed to treat the exudation and as prophylaxis to recurrent IOI. Combination therapy achieved no recurrent IOI and resolution of exudation with 8-week treatment intervals.Lessons:This case might indicate that STTA is not only an optimal treatment option for brolucizumab-related IOI but also a preventive agent for this condition.     

Methylprednisolone versus triamcinolone in painful shoulder using ultrasound-guided injection

There is little evidence about the comparative efficacy of corticosteroids in the treatment of painful shoulder. The main aim was to compare the efficacy of methylprednisolone (MTP) versus triamcinolone (TMC) in the treatment of painful shoulder using an ultrasound-guided injection. Patients with painful shoulder due to subacromial bursitis and partial or full-thickness rotator cuff tears demonstrated by musculoskeletal ultrasound received a guided-injection of MTP acetate 40 mg (12 patients) or TMC acetonide 40 mg (12 patients). Range of motion and pain visual analogue scale were registered at 10 and 30 min, 1 and 2 weeks postinjection. Two weeks postinjection, both groups reported a mean improvement in range of motion (33%) and relief of pain (61%). Relief of pain of 50% or more was observed in 92% of patients in MTP group and 50% of TMC group (p = 0.02). Two months postinjection, 50% of the patients in MTP group and 25% in TMC group reported total relief of pain (p = 0.3). Patients with painful shoulder receiving an ultrasound-guided injection of MTP or TMC have a rapid and sustained overall response. Relief of pain tends to be more rapid with MTP than TMC.