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目的:探讨糖尿病性眼肌麻痹临床特点、发病机制、治疗方法、效果及应注意问题。方法:42例糖尿病性眼肌麻痹,急性单眼发病,受累神经以动眼神经麻痹多见,其次外展神经,滑车神经及复合神经(Ⅲ+Ⅳ)罕见,36例有糖尿病史,6例眼肌麻痹为首发症状,给予降血糖、肌内注射维生素B1、弥可保、静滴血塞通、ATP、辅酶A、口服泼尼松等治疗。结果:患者治疗2～16周后治愈33例,好转6例,无效3例,随访6个月,有5例复发。结论:糖尿病性微循环病变是导致神经缺血缺氧以致变性的病理基础。经控制血糖及其他对症支持治疗后,眼肌麻痹大多均能治愈,但有少数患者在治愈后复发。
Objective: To investigate the clinical features, pathogenesis, treatment, efficacy and cautions of diabetic ophthalmoplegia. Methods: Forty-two patients with diabetic ophthalmoplegia developed acute monocular etiology. The involved nerves were more common with oculomotor nerve paralysis. Secondly, the abducens, trochlear nerves and compound nerves (Ⅲ + Ⅳ) were rare. Thirty-six patients had history of diabetes mellitus, Muscle paralysis as the first symptom, given hypoglycemic, intramuscular injection of vitamin B1, miconus, intravenous drip, ATP, coenzyme A, oral prednisone and other treatment. Results: In 2 to 16 weeks after treatment, 33 cases were cured, 6 cases improved, 3 cases were ineffective. After 6 months follow-up, 5 cases relapsed. Conclusion: Diabetic microcirculation is the pathological basis of degeneration caused by ischemia and hypoxia. After the control of blood sugar and other symptomatic and supportive treatment, mostly ophthalmoplegia can be cured, but a small number of patients relapsed after the cure.