缺血性视神经病变综合治疗的临床研究

目的研究缺血性视神经病变患者治疗前后的血液流变学情况及综合治疗效果。方法回顾分析2007—2011年在我院就诊的23名缺血性视神经病变患者病例资料，治疗前后眼部一般情况、中心视野、VEP、彩色多普勒（CDI）检查颈总动脉、颈内动脉、眼动脉的血管壁情况、内膜一中膜厚度及血流速度；睫状后短动脉、视网膜中央动脉的收缩期峰值血流速度（PSV）、舒张末期速度（EDV）、搏动指数（PI）、阻力指数（RI）。治疗方法采用激素冲击、扩血管、脱水剂、营养神经、局部复方樟柳碱注射等综合治疗。结果（1）视力：治疗前后视力比较差异无统计学意义（P〉0．05）。（2）视野：治疗后视野缺损范围显著减少，与治疗前相比差异具有统计学意义（P〈0．05）。（3）颈部、眼部血管CDI：颈动脉硬化、颈动脉粥样斑块、动脉硬化闭塞症人数治疗前与治疗后无差异。治疗后睫状后短动脉血流PSV或EDV下降7眼，占26．9％，与治疗前相比差异有统计学意义（P〈0．05）；视网膜中央动脉血流PSv或EDV下降5眼，占19．2％；眼动脉血流PSV或EDV下降3眼，占11．5％。与治疗前相比，差异均无统计学意义（P〉0．05）。结论应用综合方法治疗缺血性视神经病变能够改善患者睫状后短动脉的血液流变学．减小视野缺损范围，改善患者的视功能。

Clinical research of combined therapy on ischemic optic neuropathy

OBJECTIVE To study the hemorrheology of ischemic optic neuropathy and the effect of combined therapy. METHODS Twenty-three patients data （before and after treatment） treated for isehemic optic neuropathy in our hospital from 2007-2011 were analyzed retrospectively. The VA, CVF were researched. The VW, IMT, blood speed of CA, ICA, and OA were researched through CDI. The PSV, EDV, PI, RI of PCA, CRA were researched through CDI. The hormone shock, vasodilator agent, dehydrator, neurotrophy, anisodine were combining applied. RESULTS The difference of visual acuity before and after treatment was not statistically significant （P〈0.05）. The defect sphere of CVF after treatment was significantly decreased （P〈0.05）. The number of patients （who＇s PSV or EDV of PCA decreased ） after treatment was significantly decreased （P〈0.05）. CONCLUSIONS The combined therapy could improve blood flow rate of PCA, decrease defect sphere of CVF, improve visual function.