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目的 :探讨血栓通 (PNS)、等容血液稀释 (IHD)及二者结合治疗视网膜静脉阻塞 (RVO)对视网膜微循环的影响。方法 :采用PNS ,IHD及PNS +IHD随机对照治疗RVO患者 73例 ,观察治疗前后视网膜微循环时间 (RCT)和视网膜出血、水肿、毛细血管渗漏及黄斑囊样水肿 (CME)、无灌注区面积等的改变。结果 :与另两种方法比较 ,PNS +IHD使RCT ,尤其非缺血型和分支静脉阻塞患者RCT缩短更明显 ,视网膜出血、水肿、毛细血管渗漏及CME消退更快 ,并使病程小于两周的早期患者无灌注区发生率减低 ,缺血型者无灌注区边缘毛细血管充盈增加 ,但无灌注区面积无显著缩小。结论 :PNS结合IHD能显著缩短RVO患者RCT ,促进视网膜出血、水肿和毛细血管渗漏及CME的消退 ,可能还有减少早期患者无灌注区形成的作用。
Objective: To investigate the effects of Xueshuantong (PNS), isovolemic hemodilution (IHD) and their combination on retinal microcirculation in the treatment of retinal vein occlusion (RVO). Methods: 73 patients with RVO were randomly divided into three groups: PNS, IHD and PNS + IHD. The changes of retinal microcirculation time (RCT), retinal hemorrhage, edema, capillary leakage and cystoid macular edema (CME) Area changes. Results: Compared with the other two methods, PNS + IHD shortened the RCT of RCT, especially in non-ischemic and branch vein occlusion patients. Retinal hemorrhage, edema, capillary leakage and CME subsided more quickly and the course of disease was less than two The incidence of no perfusion zone was reduced in the early weeks of the week, while the peripheral capillary perfusion was increased in the ischemic non perfusion zone, but there was no significant decrease in the area without perfusion. CONCLUSIONS: PNS combined with IHD can significantly shorten RCT in patients with RVO and promote retinal hemorrhage, edema and capillary leakage and regression of CME, and may also reduce the effect of non-perfusion zone formation in early patients.