摘要
目的 观察后Tenon囊下注射曲安奈德治疗儿童视神经炎的临床效果及安全性.方法 选取2018年6月—2023年6月郑州市第七人民医院收治的60例(120眼)儿童视神经炎患者,随机方式进行分组,分为曲安奈德后Tenon下注射的观察组与全身应用糖皮质激素类固醇的对照组,每组均用甲钴胺、胞磷胆碱钠胶囊及复方樟柳碱注射液颞浅动脉旁皮下注射.两组患儿基线特征接近.对两组治疗1个月及3个月后的临床疗效、视觉诱发电位(visual evoked potential,VEP)、视野、光敏度、CFF-红色、绿色、黄色值检查结果进行统计分析.结果 治疗1个月后效果观察显示,观察组总有效率(96.66％)优于对照组(78.33％)(P＜0.05);观察组VEP检查显示P100波振幅为(7.58±3.54)μV,高于对照组[(6.78±3.18)μV](P＜0.05),观察组潜伏期(91.58±13.82)ms,低于对照组[(97.20±15.66)ms](P＜0.01);观察组平均视野缺损(0.54±0.33)dB,低于对照组[(0.63±0.28)dB](P＜0.01);观察组平均光敏度(22.46±3.86)dB,高于对照组[(24.87±4.17)dB](P＜0.01);观察组CFF-红色、绿色、黄色平均值[(29.64±6.94、31.66±8.42、32.64±7.68)Hz]高于对照组[(28.76±5.12、29.65±3.22、30.62±7.12)Hz],组间对比差异有统计学意义(P＜0.01).结论 后Tenon囊下注射曲安奈德治疗儿童视神经炎安全有效,无不良反应,适用基层医院推广应用.
Abstract
Objective To observe the clinical effect and safety of Tenon subcapsular injection of triamcinolone in the treatment of optic neuritis in children.Methods A total of 60 children(120 eyes)with optic neuritis admitted to Zhengzhou Seventh People's Hospital from June 2018 to June 2023 were randomly divided into an observation group re-ceiving Tenon injection after triamcinolone and a control group receiving systemic glucocorticoid steroids.Mecobalamine,citicoline sodium capsules and compound anisodine injection were given subcutaneous injection at the superficial tempo-ral artery in each group.Baseline characteristics were similar between the two groups.Clinical effiicacy,visual evoked potential(VEP),visual field,photosensitivity,CFF-red,green and yellow values were statistically analyzed after 1 month and 3 months of treatment in the two groups.Results After 1 month of treatment,the total effective rate of the observation group(96.66％)was better than that of the control group(78.33％)(P＜0.05).VEP examination showed that the P100 wave amplitude of the observation group was(7.58±3.54)μV,higher than that of the control group[(6.78±3.18)μV](P＜0.05),and the latency of the observation group was(91.58±13.82)ms,lower than that of the control group[(97.20±15.66)ms](P＜0.01).The average visual field defect in the observation group was(0.54±0.33)dB,lower than that in the control group[(0.63±0.28)dB](P＜0.01).The average photosensitivity of observation group was(22.46±3.86)dB,which was higher than that of control group[(24.87±4.17)dB](P＜0.01).The mean value of CFF-red,green and yellow[(29.64±6.94,31.66±8.42,32.64±7.68)Hz]in observation group was higher than that in control group[(28.76±5.12,29.65±3.22,30.62±7.12)Hz].The difference between groups was statistically significant(P＜0.01).Conclusion Post Tenon subcapsular in-jection of triamcinolone acetonide is safe and effective in the treatment of pediatric optic neuritis,with no adverse reac-tions,and is suitable for promotion and application in grassroots hospitals.
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