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[急性视网膜中央动脉阻塞的选择性眼动脉纤溶治疗]

[Selective ophthalmic artery fibrinolysis in acute central retinal artery occlusion].

作者信息

Fernández F J, Guelbenzu S, Barrena C, Larrosa J M, Gonzalvo F J, Melcon B, Honrubia F M

机构信息

Servicios de Oftalmología y Neurorradiología, Hospital Miguel Servet, Zaragoza, España.

出版信息

Arch Soc Esp Oftalmol. 2002 Feb;77(2):81-6.

Abstract

PURPOSE

To evaluate efficacy and reliability of local intra-arterial fibrinolysis (LIF) in Retinal Central Artery Occlusion (RCAO).

MATERIAL AND METHOD

We have studied 12 patients with RCAO. Seven patients (group I) were treated with conventional therapy and 5 patients (group II) underwent treatment with urokinase via transcutaneous femoral catheter into the ophthalmic artery. Thereafter patients received heparin sulfate for 3 days.

RESULTS

Mean follow up was 14 months and mean time from onset of symptoms to the beginning of therapy was 11 hours. One patient in group I showed improvement of visual acuity (from counting fingers to 0.1). In all patients in group II there was angiographic evidence of improved perfusion of retinal arteries and 4 patients (80%) showed improvement in visual acuity. The best results were obtained when LIF was performed before 10 hours after onset of symptoms. No complications were observed after the fibrinolysis treatment.

CONCLUSION

LIF in ophtalmic arteries for the treatment of RCAO reduces dosage of fibrinolytic agents and becomes a safe and useful treatment during the first hours post RCAO.

摘要

目的

评估局部动脉内溶栓(LIF)治疗视网膜中央动脉阻塞(RCAO)的疗效和可靠性。

材料与方法

我们研究了12例RCAO患者。7例患者(I组)接受传统治疗,5例患者(II组)经皮股动脉导管将尿激酶注入眼动脉进行治疗。此后患者接受3天的硫酸肝素治疗。

结果

平均随访14个月,从症状发作到开始治疗的平均时间为11小时。I组中有1例患者视力有所改善(从数手指提高到0.1)。II组所有患者均有视网膜动脉灌注改善的血管造影证据,4例患者(80%)视力有所改善。在症状发作后10小时内进行LIF时效果最佳。溶栓治疗后未观察到并发症。

结论

眼动脉LIF治疗RCAO可减少纤溶药物用量,成为RCAO发病后最初几小时内一种安全有效的治疗方法。

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