不同糖皮质激素治疗创伤性视神经病变90例疗效探讨  

Discussion of clinical effect of different glucocorticoids in treating 90 cases of traumatic optic neuropathy

作　　者：黄沁园[1] 周俊[2] 肖启国[2] 夏世刚[2] 肖勇[2] 

机构地区：[1]南华大学附属第一医院,湖南衡阳421001 [2]南华大学附属第二医院,湖南衡阳421001

出　　处：《现代医药卫生》2016年第4期503-505,共3页Journal of Modern Medicine & Health

摘　　要：目的分析创伤性视神经病变（TON）临床药物治疗方法并对比观察治疗效果。方法选取南华大学附属第二医院于2013年1月至2014年12月收治的患者90例（98眼）,根据患者治疗用药情况将其分为甲泼尼龙组30例（36眼）、地塞米松组30例（32眼）、对照组（不予激素常规治疗）30例（30眼）。对比观察甲泼尼龙和地塞米松在不同时间段的治疗效果。结果甲泼尼龙组和地塞米松组治疗后总有效率分别为47.22%、34.38%,对照组为13.33%。甲泼尼龙组与地塞米松组比较,差异有统计学意义（P〈0.05）,两组分别与对照组比较,差异均有统计学意义（P〈0.01）。甲泼尼龙组与地塞米松组在0-〈8、8-〈24、24-〈72 h给药有效率比较,差异均有统计学意义（P〈0.05）,而两组72 h后给药有效率比较,差异无统计学意义（P〉0.05）。结论甲泼尼龙与地塞米松均能治疗TON,甲泼尼龙对视神经损伤的治疗作用优于地塞米松。受伤后8 h内只要无禁忌证,应尽早使用糖皮质激素冲击治疗。受伤72 h后给予糖皮质激素疗效较差,是否使用还需权衡利弊。Objective To analyze the clinical medication methods for treating traumatic optic neuropathy（TON） and to contrastively observe their treatment effects. Methods Totally 90 patients（98 eyes） with TON in the Second Affiliated Hospital of University of South China from January 2013 to December 2014 were selected as the research subjects and divided into the methylprednisolone group（30 cases,36 eyes）,dexamethasone group（30 cases,32 eyes） and control group（conventional therapy without using hormone,30 cases,30 eyes）. The treatment effects of methylprednisolone and dexamethasone in different time periods were contrastively observed. Results The total effective rate after treatment in the methylprednisolone and dexamethasone groups were 47.22% and 34.38% respectively,which in the control group was 13.33%,the difference between the methylprednisolone and dexamethasone groups were statistically significant（P〈0.05）,and the difference between the methylprednisolone and dexamethasone groups with the control group was statistically significant（P〈0.01）. The effective rates in the methylprednisolone and dexamethasone groups had statistical differences among 0-8,8-24,24-72 h administration,but the administration after 72 h had no statistical difference between the two groups（P〈0.05）. Conclusion Methylprednisolone and dexamethasone can treat TON. The curative effect of methylprednisolone for treating optic nerve injury is superior to dexamethasone. As long as there is no contraindication within 8 h after injury,the glucocorticoids impact treatment should be used as soon as possible. After 72 h of injury,giving glucocorticoid has poor curative effect,moreover whether using glucocorticoid still need to weigh the pros and cons.

关 键 词：视神经损伤 甲泼尼龙 地塞米松 治疗结果 

分 类 号：R562.25[医药卫生—呼吸系统]