急性甲醇中毒致视力损害临床研究  

Clinical analysis of visual loss caused by acute methanol poisoning

作　　者：周润海[1] 高明宏[1] 刘福英[1] 李鹤一[1] 刘乙楠[1] 秦妍滨[2] ZHOU Run-hai GAO Ming-hong LIU Fu-ying LI He-yi LIU Yi-nan QIN Yan-bin(Department of Ophthalmology,The General Hospital of Shenyang Military Command, Shenyang 110016, China)

机构地区：[1]沈阳军区总医院眼科,辽宁沈阳110016 [2]沈阳军区总医院医务部,辽宁沈阳110016

出　　处：《临床军医杂志》2017年第7期685-687,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨急性甲醇中毒致视力损害的临床特点及预后。方法收集2014年4—8月收治的7例急性甲醇中毒致视力损害住院患者的临床资料。急诊住院后患者均进行视力和眼底检查,给予经纠正酸中毒、激素冲击及大剂量B族维生素辅助治疗,并对患者进行随访,探讨患者临床特点及预后情况。结果患者均急性起病,病程早期伴有全身中毒症状,同时,出现双眼不同程度的视力下降。视力下降3 d内达顶峰,7例患者14眼视力从无光感至0.5,均有色觉改变。急性期眼底视盘大致正常,病变部位以球后部视神经受累为主。随访2个月,除2例因代谢性酸中毒死亡外,其余5例患者视力均有不同程度改善。结论急性甲醇中毒可导致严重的视神经损害,全身症状重,预后差。Objective To investigate the clinical features and prognosis of the visual loss resulted from acute methanol poisoning.Methods A retrospective study was performed on 7 cases of patients with acute methanol poisoning who were admitted from April to August 2014. After emergency treatment in the hospital,patients were performed visual acuity and fundus examination,and rectification of metabolic acidosis,large dosage of B vitamins and methylprednisolone therapy were taken. Patients were followed up,the clinical characteristics and prognosis were investigated. Results All patients had acute onset,systemic symptoms early in the course,both eyes involved,and with severe visual impairment. After 3 days of onset,the visual acuity got worst. Fourteen eye-sights of seven patients were from no-light-perception to 0. 5 with color vision descent. Retrobulbar optic nerves were the major sites involved,and optic discs were normal on the acute stage. The visual function of patients got improved in different degree in the 3 months’ follow-up,except two dead patients with severe metabolic acidosis. Conclusion Acute methanol poisoning could lead to serious damage to optic nerve,and the more severe the systemic symptoms gets,the worse the prognosis will be.

关 键 词：甲醇中毒 视力损害 视神经 

分 类 号：R595.6[医药卫生—内科学]