眼动脉血管再通术治疗美容注射透明质酸致单眼失明的临床研究  

Clinical research on ophthalmic artery recanalization in treatment of monocular blind caused by facial and forehead injection of hyaluronic acid

作　　者：沈海洋 赖琳英[2] 宋浩[3] 刘涛 李倩[1] 于友涛[1] 

机构地区：[1]解放军总医院第一附属医院介入科,100048 [2]解放军总医院第一附属医院烧伤整形科,100048 [3]常州市第四人民医院介入科,213001

出　　处：《中华介入放射学电子杂志》2017年第4期259-264,共6页Chinese Journal of Interventional Radiology：electronic edition

摘　　要：目的:评估经眼动脉血管再通术治疗透明质酸鼻额部美容注射致单眼失明的安全性和疗效。方法:2015年12月—2016年12月因美容注射透明质酸于鼻额部致单眼失明的患者30例,共30根眼动脉,注射后失明至来医院时间20~120 h,采用介入血管再通术对眼动脉进行再通,并配合临床常用的药物及物理治疗。评估该组患者的技术成功率、技术相关并发症、血管再通情况、视觉恢复情况、眼球与眼睑活动度恢复等情况。结果:本组30例均成功完成眼动脉灌注药物及导丝器械再通,眼动脉介入再通术技术成功率100%(30/30)。治疗1个月后复查,全部30例患者中5例患者视觉恢复,恢复率16.7%(5/30),7例患者恢复光感,恢复率23.3%(7/30)。全部30例患者眼球出血与眼睑麻痹消失,药物注射部位局部肿胀消失,皮肤损伤基本愈合,复查眼底见视网膜血管均能再通及明显显影。结论:经眼动脉介入血管再通术治疗透明质酸鼻额部美容注射所致的失明,是安全、有效、快捷的方法。眼肌及其支配神经的缺血损伤在开通栓塞血管后可逐步恢复,但视觉恢复是一个较为缓慢的、需多种方法综合治疗的过程。Objective： To evaluate the safety and efficacy of ophthalmic artery recanalization intreatment of monocular blind caused by facial and forehead injection of hyaluronic acid. Methods： Thirty monocular blind patients who had hyaluronic acid injections before had interventional recanalization from December 2015 to December 2016. It took 20 ~120 h from injection to hospital. The ophthalmic artery recanalization was performed by interventional recanalization, and the drugs and physical therapy were also used. The technical success rate, complications related to technique, recanalization of blood vessels, visual recovery, and recovery of ocular and eyelid movements were evaluated. Results ： The success rate of ophthalmic artery interventional recanalization was 100% （30/30）. 1 month after operation, 5 of 30 patients obtained visual recovery, with recovery rate of 16.7% （5/30）, 7 of 30 patients obtained light perception, with recovery rate of 23.3% （7/30） . In all 30 patients, eyeball hemorrhage and eyelid paralysis disppeared, swelling loci of medicine injection dissipated, and skin was healed basically, fundus fluorenscein angiograhy showed retinal revascularization and obvious development. Conclusions ： It is a safe, effective and efficient therapy of ophthalmic artery recanalization in the treatment of monocular blind caused by facial and forehead injection of hyaluronic acid. Ischemic damage of the eye muscle and its dominant nerve were gradually restored after recanalization. Because of the sensitivity of retina for ischemia injury, visual recovery can be more difficult. Visual recovery treatment is a slow and comprehensive treatmentprocess in a v a r ie ty o f w a y s.

关 键 词：透明质酸 美容注射 失明 眼球眼睑损伤 介入血管再通术 透明质酸溶解酶 

分 类 号：R77[医药卫生—眼科]