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目的:探讨2型糖尿病性眼肌麻痹的临床特点,并观察使用前列地尔联合甲钴胺治疗的疗效。方法:回顾性分析2008-2014年于我院内分泌科住院的21例糖尿病性眼肌麻痹患者的临床特点和治疗情况,并进行探讨。结果:21例糖尿病眼肌麻痹患者均为单眼患病,其中动眼神经麻痹14例,外展神经麻痹7例;9例有高血压,8例有高脂血症。患者均接受前列地尔联合甲钴胺治疗2周,出院后随诊3月,痊愈13例,好转8例,痊愈组患者糖化血红蛋白更低、糖尿病病程更短。结论:糖尿病眼肌麻痹中动眼神经受累最常见,外展神经次之;病程和糖化血红蛋白是影响预后的危险因素;前列地尔联合甲钴胺治疗糖尿病眼肌麻痹安全有效。
Objective: To investigate the clinical features of type 2 diabetic ophthalmoplegia and to observe the curative effect of using prostaglandin combined with mecobalamin. Methods: The clinical features and treatment of 21 patients with diabetic ophthalmoplegia hospitalized in Department of Endocrinology in our hospital from 2008 to 2014 were analyzed retrospectively. Results: Twenty-one patients with ophthalmoplegia of diabetes mellitus were monocular, including 14 cases of oculomotor nerve palsy and 7 cases of abducens paralysis; 9 cases of hypertension and 8 cases of hyperlipidemia. Patients were treated with alprostadil combined with mecobalamin for 2 weeks, followed up 3 months after discharge, cured 13 cases, improved in 8 cases, patients in recovery group had lower HbA1c and shorter duration of diabetes. Conclusion: The most common oculomotor nerve involvement in the ophthalmoplegia of diabetes mellitus, followed by the outreach neuropathy; the course of disease and glycosylated hemoglobin are the risk factors of prognosis; and the combination of alprostadil and mecobalamin in the treatment of diabetic ophthalmoplegia is safe and effective.