增强型体外反搏联合药物治疗视网膜中央动脉阻塞的疗效

目的 探讨增强型体外反搏(EECP)联合药物治疗视网膜中央动脉阻塞( CRAO) 的疗效。方法 选择2020年5月—2021年5月我院诊治的视网膜中央动脉阻塞患者共48例（48眼）作为观察对象，根据治疗方法分为观察组22例（22眼）和对照组26例（26眼）,另选取我院同期体检的健康人群20例（20眼）作为阴性对照组。观察组进行4个疗程的EECP联合药物治疗；对照组予单纯药物治疗；阴性对照组予单纯4个疗程EECP治疗。根据治疗前后患者视力、黄斑区血流密度、颈内动脉舒张期末血流速度（EDV）、收缩期峰值血流速度（PSV）及阻力指数（RI）等指标变化，评价及比较疗效。结果 观察组总有效率高于对照组（χ2=7.968，P＜0.05）。观察组视力治疗后较治疗前显著提高，差异有统计学意义（P＜0.05），对照组视力治疗后无明显提高，差异无统计学意义（P＞0.05）。病程越短，EECP联合药物治疗效果越好，两者呈高度负相关（r=-0.837，P＜0.05）。阴性对照组治疗后颈内动脉各项血流动力学指标较治疗前明显增加，治疗后RI较治疗前明显减小，差异有统计学意义（P＜0.05）；治疗后黄斑区血流密度各项指标较治疗前明显增加，差异有统计学意义（ P＜0.05）。观察组治疗后EDV与PSV较治疗前明显增加，治疗后RI较治疗前明显减小，差异有统计学意义（P＜0.05）。对照组治疗前后EDV、PSV及RI均无明显改善，差异无统计学意义（P＞0.05）。观察组治疗后黄斑区SCP与DCP血流密度较治疗前明显增加，差异均有统计学意义（P＜0.05）。对照组治疗前后黄斑区SCP与DCP血流密度无明显变化，差异无统计学意义（P＞0.05）。结论 EECP联合药物治疗视网膜中央动脉阻塞，可显著提高CRAO患者的临床疗效，可在临床推广应用

Efficacy of enhanced external counterpulsation combined with drugs in the treatment of central retinal artery occlusion

Objective To investigate the efficacy of enhanced external counterpulsation (EECP) combined with drugs in the treatment of Central retinal artery occlusion（CRAO）. Methods A total of 48 patients (48 eyes) with central retinal artery occlusion diagnosed and treated in our hospital from May 2020 to May 2021 were selected as the research subjects. According to the treatment methods, they were divided into the experimental group of 22 cases (22 eyes), the physical disease control group of 26 cases (26 eyes), and the normal control group of 20 cases (20 eyes). The experimental group received 4 courses of EECP combined with drugs, the physical disease control group was treated with simple drugs and the normal control group received 4 courses of EECP. According to the changes of visual acuity, macular blood flow density, internal carotid artery end-diastolic blood flow velocity (EDV), peak systolic blood flow velocity (PSV) and resistance index (RI) before and after treatment, the curative effects of the two groups were evaluated and compared. Results The total effective rate of the experimental group was 77.3%, while that of the physical disease control group was 53.8%. There was significant difference in the total effective rate between the two groups (P＜0.05). Postoperative VA of the experimental group was significantly improved than that preoperative (P＜0.05), while no significant difference existed between preoperative and postoperative VA of the physical disease control group (P＞0.05). The shorter the duration of disease, the better the clinical efficacy of medication-combined EECP. The clinical efficacy was highly and negatively correlative with the duration of diseases (P＜0.05). The hemodynamic indexes of the internal carotid artery in the normal control group after treatment were significantly increased compared with those before treatment, results the RI after treatment was significantly decreased (P<0.05). After treatment, the indexes of macular blood flow density were significantly increased compared with those before treatment, the difference was statistically significant (P<0.05). The experimental group after treatment were significantly increased in EDV and PSV while significantly decreased in RI (P<0.05). In the physical disease control group, the EDV,PSV and RI were not different comparing before and after treatment(P>0.05). The experimental group after treatment were significantly increased in the blood flow densities of SCP and DCP in the macular area (P<0.05). There was no significant change in the blood flow densities of SCP and DCP in the macular area before and after treatment in the physical disease control group, and the difference was not statistically significant (P>0.05). Conclusion EECP combined with drugs in the treatment of central retinal artery occlusion can significantly improve the clinical efficacy of patients with CRAO, which is worthy of clinical applicatio