眶内电针治疗Fisher综合征所致眼肌麻痹临床观察  

Clinical Observation of Intra-Orbital Electroacupuncture against Miller Fisher Syndrome Ophthalmoplegia

作　　者：周凌云[1] 郭晓雪 苏畅 刘微[2] 吴秀亭 王家运 刘铁镌[1] 栗雪梅 赵明[1] 纪晓杰[1] ZHOU Ling-yun;GUO Xiao-xue;SU Chang;LIU Wei;WU Xiu-ting;WANG Jia-yun;LIU Tie-juan;LI Xue-mei;ZHAO Ming;JI Xiao-jie(Harbin Medical University Affiliated First Hospital,Harbin 150001,China;Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]哈尔滨医科大学附属第一医院针灸科,哈尔滨150001 [2]黑龙江中医药大学,哈尔滨150040

出　　处：《神经损伤与功能重建》2020年第4期204-206,共3页Neural Injury and Functional Reconstruction

基　　金：国家自然科学基金(No.81674052);黑龙江中医药科研项目(No.ZHY12-W031)。

摘　　要：目的:回顾分析眶内电针(IEA)治疗Fisher综合征(MFS)眼肌麻痹疗效及MFS眼肌麻痹患者的临床特点。方法:收集接受IEA治疗的MFS患者27例的资料,对一般资料、受累颅神经、感染情况、治疗前后最大复视角度、治疗及恢复情况等进行回顾分析。结果:患者从发病到开始接受IEA治疗的平均时间为(31.04±46.23)d,接受治疗后达到临床痊愈的平均天数为(33.67±21.96)d。临床痊愈(无复视致残)24例(88.9%)。治疗后,左眼和右眼的最大复视角度均较治疗前显著降低(P<0.01)。MFS眼肌麻痹特点:100%患者有外展神经病变,其中11.1%为单侧病变,88.9%为双侧受累;37.0%合并III、VI对颅神经麻痹,无孤立的III或IV对颅神经麻痹患者。70.3%有感染史;11.1%伴发高血压、7.4%伴发高脂血症、3.7%伴发2型糖尿病。22.2%伴有Bell征,双侧受累4例,单侧受累2例。25.9%眼睑下垂,双侧受累5例,单侧受累2例。3.7%伴有双侧瞳孔散大。结论:IEA治疗可加快MFS眼肌麻痹症状恢复,MFS眼肌麻痹的临床特点可提示临床诊断。Objective:To review the effectiveness of intra-orbital electroacupuncture(IEA)in the treatment of Miller Fisher Syndrome(MFS)ophthalmoplegia and the clinical characteristics of MFS ophthalmoplegia.Methods:We reviewed the medical records of 27 MFS ophthalmoplegia patients who received IEA therapy and retrospectively analyzed the general data,infection status,maximum diplopia deviation before and after treatment,and treatment and recovery status.Results:The mean time from onset to the start of IEA treatment in patients was(31±46.23)days,and the mean time from treatment to recovery was(33.67±21.96)days.The number of patients clinically cured(no diplopia)was 24(88.9%).After treatment,the average maximum diplopia deviation of the left and right eye was significantly decreased(P<0.01).Abducens nerve(CN VI)paralysis was seen in 100%of patients with 11.1%being unilaterally affected and 88.9%bilaterally affected.Combined CN III and VI paralysis occurred in 37.0%of patients,and isolated CN III and CN IV paralysis was not seen.Infection was seen in70%of patients.Concomitant disease included hypertension(11.1%),hyperlipemia(7.4%),and type 2 diabetes(3.7%).Bell’s phenomenon was seen in 22.2%of patients including 4 bilateral and 2 unilateral cases.Ptosis occurred in 25.9%of patients including 5 bilateral and 2 unilateral cases.Bilateral pupil dilation was seen in 3.7%of patients.Conclusion:IEA therapy may accelerate the recovery from MFS ophthalmoplegia,and the clinical features of MFS ophthalmoplegia may aid diagnosis.

关 键 词：眶内电针 FISHER综合征 眼肌麻痹 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.02[医药卫生—临床医学]