掺钕钇铝石榴石激光击栓术治疗视网膜分支动脉阻塞的初步报告  

Preliminary report of Nd:YAG laser embolysis for branch retinal artery occlusion

作　　者：卢宁[1] 杨庆松[1] 马凯[1] 周海英[1] 熊颖[1] 严伟[1] 

机构地区：[1]首都医科大学北京同仁眼科中心,100730

出　　处：《中华眼科杂志》2006年第4期326-329,共4页Chinese Journal of Ophthalmology

摘　　要：目的探讨掺钕钇铝石榴石（Nd：YAG）激光击栓术治疗视网膜分支动脉阻塞的临床效果。方法选择视网膜分支动脉阻塞的患者进行Nd：YAG激光治疗。治疗前检查视力和眼底，确定动脉栓子的部位并行眼底照相。治疗后立即进行眼底照相，并与治疗前图像对比分析，之后定期复查。随访时间为2周至4个月，平均1．6个月。结果共治疗7例患者，其中男性5例，女性2例；年龄为49～73岁，平均61岁；病程为1d至2个月，平均13d。治疗前视力为0．06至0．8；眼底可见典型的分支动脉阻塞表现。所有患者治疗后动脉管径均立即增粗，荧光素眼底血管造影检查显示血流完全恢复，患者自觉视力改善，检查视力为0．2～1．0。多数患者视野检查显示在相应的动脉分布范围内仍有视野缺损区。在治疗过程中，偶见局部小出血，仅2例患者术中因击破邻近静脉引起玻璃体积血，观察2周后，逐渐吸收。未见其他并发症。结论Nd：YAG激光击栓术是治疗视网膜分支动脉阻塞的有效方法，见效快且相对安全。Objective In this study, the clinical effect of the Nd：YAG laser embolysis on branch retinal artery occlusion was evaluated. Methods A fundus contact lens was used to focus the Nd：YAG laser on the embolus within the retinal arteriole. 0. 8 to 0. 9 mJ of laser pulse was delivered directly to the embolus. Fundus photographs were taken before and immediately after the treatment. Follow-up time ranged from 2 weeks to 4 months, average about 7 weeks. Seven cases received the treatment, including 5 male and 2 female patients. Age of those cases ranged from 49 to 73, average 61 years. The duration of the disease ranged from 1 to 60 days, average 13 days. Results Before treatment, visual acuity ranged from 0. 06 to 0. 8. Embolus can be detected in all the 7 cases. After treatment, all the cases showed immediate recovery of blood flow in the occluded arteriole both in fundus examination and fundus fluorescein angiography. The vision in the patients was improved in the follow-up. Visual acuity ranged from 0. 2 - 1.0. In most cases, visual field defect still existed in the ischemic area. Complications included local retinal hemorrhages in some cases and vitreous hemorrhage, but those hemorrhages were gradually absorbed and did not affect the final visual prognosis. Conclusions Nd： YAG laser embolysis for branch retinal artery occlusion is an effective treatment and the treatment is relatively safe.

关 键 词：视网膜动脉闭塞 激光击栓术 钕钇铝 眼底照相 

分 类 号：R779.63[医药卫生—眼科]