玻璃体腔内注射曲安奈德治疗Vogt-小柳原田病的效果及围术期护理  

Clinical efficacy and perioperative nursing care of intravitreal injected triamcinolone acetonide for Vogt- Koyanagi-Harada disease

作　　者：汪波[1] 高丰[1] 刘旭[1] 赵青[1] 

机构地区：[1]湖北医药学院附属襄阳医院感染性疾病科,441000

出　　处：《中华现代护理杂志》2015年第13期1533-1536,共4页Chinese Journal of Modern Nursing

摘　　要：目的探讨玻璃体腔内注射曲安奈德（TA）治疗Vogt-小柳原田病（VKH综合征）的临床疗效及其护理方法。方法为前瞻性临床对照研究设计，选择2013年1月—2014年6月经诊断Vogt-小柳原田病的32例急性期患者，采用随机数字表法随机分为对照组（16例，32眼）和观察组（16例，32眼）。对照组给予糖皮质激素常规治疗和护理，观察组给予糖皮质激素常规治疗的同时，另给予TA玻璃体腔内注射，同时进行心理护理及病情观察。两组患者分别在治疗前及治疗后1周，1，3，8个月时常规行视力、眼压、光学相干断层扫描（OCT）及眼底荧光血管造影（FFA）检查，比较治疗前后最佳矫正视力、OCT检测黄斑中心凹厚度、FFA检查及眼压恢复情况，并对数据进行分析。结果治疗后不同时期，两组患者视力皆有提高，但观察组视力提高更明显，治疗3个月后观察组视力为（0．43±0．25），对照组视力为（0．30±0．05），两组差异有统计学意义（t=6．83，P〈0．05）；治疗3个月后观察组黄斑区视网膜神经上皮层厚度为（162±57）μm，对照组为（296±74）μm，两组差异有统计学意义（r=-2．87，P〈0．05）；治疗3个月后观察组FFA检查视网膜血管荧光渗漏、管壁着染等均消失，对照组仍有4例患者存在视网膜血管荧光渗漏现象。结论全身使用糖皮质激素联合玻璃体腔内注射TA配合精心的护理是治疗Vogt-小柳原田病的有效方法，使患者的视力显著提高，治疗效果满意，临床值得推广。Objective To investigate the clinical efficacy and perioperative nursing care of intravitreal injected triamcinolone acetonide （TA） for Vogt-Koyanagi-Harada disease （VKH syndrome）. Methods For a clinical prospective controlled study, a total of 32 cases diagnosed as VKH disease were randomly divided into treatment group （ 16 cases 32 eyes） and control group （ 16 cases 32 eyes）. The patients of control group received conventional glucocorticoid therapy, while the patients of treatment group received corticosteroid treatment and intravitreal injected TA, and mental nursing were provided and condition observed at the same time. Before treatment and on one week, 1,3,8 months after treatment, the two groups of patients were regularly detected visual acuity, intraocular pressure, optical coherence tomography （OCT） and fundus fluorescein angiography （FFA） in order to compare the best corrected visual acuity and the foveal thickness, recovery of FFA, recovery of intraocular pressure before and after treatment, and the data were analyzed. Results In different periods after treatment, visual acuity had improved in both group, but there was a more improvement in the treatment group. Visual acuity was （0.56 ± 0.25） in the treatment group while （0.30 ± 0.05 ） in the control group after three months treatment, the difference was statistically significant between two groups （t = 6. 83, P 〈 0. 05 ）. Three months later after the treatment, macular retinal nerve cortical thickness was （162 ± 57） μm on the treatment group, and that of the control group was （296 ± 74） μm, the difference was statistically significant between two groups （ t = - 2. 87, P 〈 0. 05 ）. FFA examination showed that the retinal vascular of luorescence leakage and the wall staining disappeared after three months treatment, but there were still four patients having the retinal vascular fluorescence leakage existed in the control group. Conclusions Systemic corticosteroids combined with intravitreal injec

关 键 词：曲安奈德 围手术期护理 VOGT-小柳原田病 玻璃体腔注射 

分 类 号：R473.77[医药卫生—护理学]