标题：视神经管骨折患者术后糖皮质激素治疗效果及安全性分析

      作者：何华 1，周峰 2    榆林市第一医院眼科 1、神经外科 2，陕西 榆林 718000

      卷次： 2020年31卷5期

      【摘要】 目的 探讨视神经管骨折患者术后应用糖皮质激素治疗的疗效及安全性。方法 选取2014年6月至2019年4月榆林市第一医院收治的68例视神经管骨折患者作为研究对象，采用随机数表法将患者分为观察组和对照组各34例。两组患者均进行视神经管减压手术治疗，对照组于术后进行常规抗生素、能量合剂等治疗，观察组在对照组基础上联合使用糖皮质激素治疗。比较两组患者术后1 d、3 d、2周、4周的前房浮游细胞阴性时间、前房闪辉值、眼部症状评分和眼压值，以及治疗期间的不良反应发生情况。结果 术后用药期间观察组患者的前房浮游细胞阴性时间为(5.81±1.16) d，明显高于对照组的(3.79±0.52) d，差异有统计学意义(P<0.05)；同时两组患者术后3 d、术后2周和术后4周的前房闪辉值、眼部症状评分和眼压值明显低于术后1 d，差异均有统计学意义(P<0.05)，且观察组术后3 d、术后2周和术后4周的前房闪辉值[(6.79±1.78) pc/ms、(5.86±1.12) pc/ms、(5.37±1.09) pc/ms]和眼部症状评分[(6.26±1.23)分、(4.68±1.12)分、(2.27±0.79)分]明显低于对照组 [(8.81±2.05) pc/ms、(8.09±2.38) pc/ms、(7.02±1.47) pc/ms]和[(8.24±1.31)分、(7.09±1.37)分、(5.32±0.84)分]，差异均有统计学意义(P<0.05)；观察组患者术后4周的眼压值为(16.37±2.89) mmHg，明显高于对照组的(15.02±2.34) mmHg，差异有统计学意义(P<0.05)；两组患者术后治疗期间的不良反应发生率比较差异无统计学意义(P>0.05)。结论 视神经骨折患者术后短期使用糖皮质激素治疗可有效减轻前房炎症反应，改善患者眼部症状，且安全性好。
      【关键词】 视神经管骨折；糖皮质激素；炎症反应；眼压；不良反应
      【中图分类号】 R774.6 【文献标识码】 A 【文章编号】 1003—6350（2020）05—0611—04

Curative effect and safety of glucocorticoid therapy on patients with optic canal fracture after surgery.
HE Hua 1, ZHOUFeng 2. Department of Ophthalmology1, Department of Neurosurgery 2, Yulin First Hospital, Yulin 718000, Shaanxi, CHINA
【Abstract】 Objective To explore curative effect and safety of glucocorticoid therapy on patients with optic ca-nal fracture after surgery. Methods A total of 68 patients with optic canal fractures, who admitted to Yulin First Hospi-tal from June 2014 to April 2019 were enrolled and divided into the observation group and control group according torandom number table method, with 34 patients in each group. Both groups were treated with optic canal decompression.After surgery, the control group was treated with routine antibiotics and energy mixtures. On basis of the control group,the observation group was treated with glucocorticoid. At 1 d, 3 d, 2 weeks and 4 weeks after surgery, negative time ofanterior chamber floating cells, anterior chamber scintillation value, scores of ocular symptoms, intraocular pressure val-ue and occurrence of adverse reactions during treatment were compared between the two groups. Results During post-operative medication, the negative time of anterior chamber floating cells in the observation group was (5.81±1.16) d,which was significantly longer than (3.79±0.52) d in the control group (P<0.05). At 3 d, 2 weeks and 4 weeks after sur-gery, anterior chamber scintillation value, scores of ocular symptoms and intraocular pressure value were significantly low-er than those at 1 d after surgery in both groups (all P<0.05). At 3 d, 2 weeks and 4 weeks after surgery, anterior chamber