95例单侧动眼神经麻痹的临床研究  

The clinical research of unilateral oculomotor nerve paresisa series of 95 patients

作　　者：侯豹可[1] 魏世辉[1] 

机构地区：[1]解放军总医院眼科

出　　处：《中国实用眼科杂志》2007年第4期413-415,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的分析单侧动眼神经麻痹的病因、治疗方法、效果以及预后情况。方法回顾性分析本院1995年5月-2005年5月诊断为单侧动眼神经麻痹的95例住院患者。结果单侧动眼神经麻痹的主要病因为颅内动脉瘤（49.5%）,进一步分析表明绝大多数（87%）患者动脉瘤位于基底节或是后交通动脉附近;其次为糖尿病性外周神经麻痹（26.3%）;虽然经一系列的检查（如：DSA、MRI、颈内血管超声等）仍有11.5%的患者不能明确致病原因。单侧动眼神经麻痹患者预后不佳,有26.3%的患者虽然经过多种治疗方案（如：营养神经,改善微循环,降低血糖或血脂等）病情仍然没有改变,51.5%患者经过一定周期治疗后病情好转,但是治愈率仅22.2%。收入单侧动眼神经麻痹患者最多的三个科室依次为神经内科,神经外科以及内分泌科;而眼科只占到了9.5%,其中绝大多数是外伤患者（5例）。结论引起单侧动眼神经麻痹的病因多样,而预后除糖尿病性麻痹外一般不佳;仍需临床资料的不断积累才能确定各种病因引起的单侧动眼神经麻痹患者的最佳治疗方案;眼科医生临床遇单侧动眼神经麻痹的患者应该充分考虑颅内动脉瘤的危险性。Objective AIM To analyze the etiopathogenisis, treatments, dffectiveness and prognosis of unilateral oculomotor nerve paresis. Methods Analysis 95 cases of unilateral oculomotor nerve paresis of the hospital from May 19995 to May 2005 retrospectively, Results The 2 main causes of disease were intracranial aneurysm（ICA 49.5%）, further data showed that most aneurism of ICA（87%） located beside basal ganglia and posterior communicating artery, and diabetic peripheral nerve paralysis（26.3%）; although varied examinations carried（including DSA, MRI and internal carotid ultrasound）, 11.5%（11 cases） could not get final diagnosis. The prognosis of unilateral oculomotor nerve paresis was unfavorable： although received several courses of treatments （such as nerve nutrition, microcirculation improvement, to cut blood glucose and blood fat down）, 26.3%（25 case） of patients felt no better, 51.5% improved, but the cure rat was only 22.2%. the 3 main divisions which treated the patients were neural medical department, neurosurgery and endocrine department; otherwise only 9.5% of patients were in ophthalmology department（most of them were trauma）. Conclusion Many courses could lead to unilateral oculomotor nerve paresis; there was always unfavorable prognosis except for diabetic peripheral nerve paresis; more clinical data was needed to draw the conclusion of which treatment was the best; when met the patients of oculormotor nerve paresis, the ophthalmologists should paid much attention to the possibility of aneurysm.

关 键 词：眼肌麻痹 动眼神经疾病 动脉瘤 

分 类 号：R771.3[医药卫生—眼科]