眼动脉逆行与顺行介入治疗视网膜中央动脉阻塞的对比观察
Comparative Observation of Retrograde and Interventional Therapy for Central Retinal Artery Occlusion
DOI: 10.12677/HJO.2017.61007, PDF, HTML, XML, 下载: 1,591  浏览: 4,681 
作者: 王润生, 杜善双：西安市第四医院眼科，陕西 西安；雷 涛, 钱 露：西安市第四医院内科，陕西 西安；王 毅, 郑 轶：西安市第四医院介入科，陕西 西安；吕沛霖：西安市第一医院眼科，陕西 西安
关键词: 视网膜动脉阻塞；眼动脉逆行介入；溶栓术；数字减影血管造影；Retinal Artery Occlusion； Ophthalmic Artery Retrograde Intervention； Thrombolytic Therapy； Angiography Digital Subtraction
摘要: 目的：对比眼动脉逆行和顺行介入治疗CRAO的疗效。方法：平均发病时间22h的CRAO者50只眼，分为眼动脉逆行介入组26眼，眼动脉顺行介入组24眼，均在DSA下采用尿激酶40万U、罂粟碱30mg进行溶栓治疗，最后从DSA，FFA，视力的改变进行分析。结果：逆行、顺行治疗后均见眼动脉及其分支增粗循环加快和眼环显著，FFA有效率相似，视力改善相似，在介入及随访过程中均无全身、眼部合并症。结论：眼动脉逆行和顺行介入溶栓治疗CRAO均可取得较好的疗效，逆行安全性高。
Abstract: Objective: To evaluate the clinical efficiency of retrograde as a novel method and interventional therapy for central retinal artery occlusion (CRAO). Method: CRAO 50 eyes with average onset time of 22 h, were divided into ophthalmic artery retrograde group with 26 eyes, ophthalmic artery intervention group with 24 eyes. All eyes were used urokinase 400000U, papaverine 30 mg under DSA for thrombolysis treatment, and then DSA, FFA, vision changes were analyzed. Results: Retrograde and intervention treatment were found enlargement of ophthalmic artery and its branches, and eye ring accelerated circularly. FFA showed the efficient change and vision im-provement are similar in both groups, and there are no body and eye complications occurred in the process of intervention and follow-up. Conclusion: Ophthalmic artery retrograde and interventional thrombolysis therapy for CRAO can obtain same effect, and the former as a developed novel ophthalmic artery retrograde intervention method showed high safety.
文章引用：王润生, 雷涛, 钱露, 杜善双, 王毅, 郑轶, 吕沛霖. 眼动脉逆行与顺行介入治疗视网膜中央动脉阻塞的对比观察[J]. 眼科学, 2017, 6(1): 35-44. https://doi.org/10.12677/HJO.2017.61007

参考文献

[1] Beatty, S. and Au Eong, K.G. (2000) Local Intra-Arterial Fibrinolysis for Acute Occlusion of the Central Retinal Artery: A Meta Analysis of the Published Data. British Journal of Ophthalmology, 84, 914-916.
https://doi.org/10.1136/bjo.84.8.914
[2] 姜金利, 李宝民, 马志忠, 等. 局部动脉内溶栓治疗视网膜中央动脉阻塞26例报告[J]. 解放军医学杂志, 2004, 29(4): 356-357.
[3] 姚勇, 沈晓文, 吴又凯, 等. 超选插管灌注溶栓药治疗视网膜中央动脉阻塞[J]. 中华眼底病杂志, 2005, 21(1): 16-19.
[4] 赵喜庆, 孟祥靖, 吉训明, 等. 经眼动脉超选插管溶栓治疗视网膜中央动脉阻塞[J]. 中华眼底病杂志, 2005, 21(1): 22-24.
[5] 丁宁, 赤克美, 王虔, 等. 超选择眼动脉内溶栓治疗视网膜中央动脉阻塞[J]. 医师进修杂志, 2005, 28(19): 51-52.
[6] 翟文娟, 时冀川, 王玉祥. 视网膜中央动脉阻塞的颈内动脉造影检查和介入溶栓治疗[J]. 中华眼底病杂志, 2005, 21(1): 20-21.
[7] 王润生, 钱路, 王毅, 等. 眼动脉分支逆行介入溶栓治疗视网膜中央动脉阻塞疗效观察[J]. 中华眼底病杂志, 2016, 32(4): 377-381.
[8] 王润生, 雷涛, 王毅, 等. 超选择性眼动脉及选择性颈动脉溶栓治疗视网膜中央动脉阻塞的疗效观察[J]. 中华眼底病杂志, 2014, 30(5): 450-453.
[9] 王润生, 吕沛霖, 王宾, 等. 视网膜中央动脉阻塞患者视网膜循环时间与中心视力损害的关系[J]. 中华眼底病杂志, 2007, 23(3): 177-179.
[10] 罗树明, 汪凯. 脑血管病[M]//贾建平. 神经病学. 北京: 人民卫生出版社, 2010: 182-183.
[11] Egan, R.A. and Starvern, R.V.J. (2015) Should Patients with Acute Central Retinal Artery Occlusions Be Treated with Intra-Arterial t-PA? Journal of Neuro-Ophthalmology, 35, 205-209.
https://doi.org/10.1097/WNO.0000000000000231
[12] Mirshahi, A., Feltgen, N., Hansen, L.L., et al. (2008) Retinal Vascular Occlusions. Deutsches Ärzteblatt International, 105, 474-479.
[13] Biousse, V. (2008) Thrombolysis for Acute Central Retinal Artery Occlusion: Is it Time? American Journal of Ophthalmology, 146, 631-634.
[14] 王润生, 李官禄, 王为农, 等. 眼动脉逆行药物灌注术临床小结[J]. 中国实用眼科杂志, 2000, 18(4): 223-224.
[15] 雷涛，王润生，吕沛霖, 等. 缺血性脑血管病患者眼动脉及其主要分支的数字减影血管造影观察[J]. 中华眼底病杂志, 2012, 28(5): 489-492.

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