超选择眼动脉溶栓介入治疗视网膜中央动脉阻塞  

Thrombolysis infusion via super selective ophthalmic artery catheterization treating central retinal artery occlusion

作　　者：郭丽[1] 吴航[1] 吉训明[1] 方薇[1] 

机构地区：[1]首都医科大学宣武医院眼科,100053

出　　处：《眼科》2007年第4期246-249,共4页Ophthalmology in China

摘　　要：目的评价超选择动脉介入溶栓治疗视网膜中央动脉阻塞的初步疗效。设计回顾性病例系列。研究对象21例(21眼)视网膜中央动脉阻塞患者。主要指标视力及手术并发症。方法经检眼镜检查及荧光素眼底血管造影检查证实为视网膜中央动脉阻塞患者21例,通过Seldinger技术经微导管超选择眼动脉推注尿激酶溶栓治疗。结果21例患者中10例经超选颈内动脉造影显示眼动脉主干狭窄和阻塞,11例眼动脉主干显影,全部患者均成功进行了溶栓治疗。溶栓治疗前、治疗后3天视网膜中央动脉显影时间分别为(38.18±10.86)秒、(12.65±3.30)秒(t=-11.89,P=0.000)。平均随访(3.23±1.26)个月。治疗后4例患者视力>0.25,9例视力不同程度改善,8例视力无变化。结论超选择眼动脉溶栓介入治疗视网膜动脉阻塞可改善患者视力,但需迅速完成内科、神经科及眼科诊断.尽快治疗。Objective To evaluate the treament of central retinal artery occlusion by thrombolysis infusion via super selective ophthalmic artery catheterization. Design Retrospective, observational case series. Participants 21 eyes of 21 patients with CRAO. Methods 21 patients with CRAO were diagnosed by stereoscopic color fundus photography and flouorescein fundus angiography, and were treated by urokinase infusion via super select ophthalmic artery catheterization seldinger technique. Main Outcome Measures Visual acuity and the postoperative complications. Results In the 21 patients, 10 had showed the occlusion of ophthalmic arterial trunk by super selective internal carotid artery angiography, the others can be found the appearance of ophthalmic arterial trunk and all patients had undergone thrombolysis therapy successfully. Imaging times of central retinal artery before and after thrombolysis infusion treatment are 38.18±10.86 seconds, 12.65±3.30 seconds （t=-11.89,P=0.000）. Mean follow-up time is 3.23±1.26 months. After the treatment, the visual acuity was more than 0.25 in 4 patients, improved to different extent in 9 and remained unchanged in 8. Conclusions Super selective arterial catheterization with thrombolysis for CRAO can improve the visual acuity of the patients, a speedy execution of all internal, neurological, and ophthalmology diagnostic measures; and a prompt therapy are necessary.

关 键 词：选择性动脉内溶栓治疗 视网膜动脉阻塞/治疗 

分 类 号：R774.1[医药卫生—眼科]