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目的观察和评价甲古胺(弥可保)对视神经挫伤的疗效。方法将58例(60眼)视神经挫伤患者随机分为弥可保组(观察组)和VitB12组(对照组),观察组给予弥可保500mg联合VitB1100mg肌注,1次/d,2~3个疗程后改为口服弥可保500mg联合VitB110mg口服,3次/d。治疗3~12个月,平均(5.5±1.8)个月。治疗期间定期随诊视力和对比敏感度及视野。结果治疗组视力恢复有效率为83.3%,对照组视力恢复有效率为60%,结果差异有统计学意义(2χ=4.022,P=0.045)。对比敏感度二组间比较显示,能识辨检查图者治疗组由治疗前的11眼增至治疗后29眼,差异有统计学意义(χ2=4.572,P=0.04),治疗组由治疗前的8眼增至治疗后12眼。治疗前2组间对比度值无统计学意义,治疗后治疗组的对比度值较对照组更明显(P<0.05)。治疗组的13眼末次检查视野范围较治疗前扩大或dB值提高者10眼,3眼视野丧失或无变化。对照组的7眼中,视野好转和丧失无变化分别为3眼和4眼。治疗前后治疗组疗效好于对照组。结论弥可保治疗视神经挫伤是安全有效的,对视功能的恢复明显优于普通VitB12。
Objective To observe and evaluate the efficacy of methylamine (Mi-Bao-Bao) on optic nerve contusion. Methods 58 cases (60 eyes) of optic nerve contusion patients were randomly divided into Miqibao (observation group) and VitB12 group (control group). The observation group was given Miqibao 500mg intramuscular injection of VitB1100mg once a day, After a course of treatment changed to oral Mi Kebao 500mg combined VitB110mg orally, 3 times / d. Treatment for 3 to 12 months, mean (5.5 ± 1.8) months. Regular follow-up during treatment of visual acuity and contrast sensitivity and visual field. Results The effective rate of visual acuity recovery was 83.3% in the treatment group and 60% in the control group. The difference was statistically significant (2χ = 4.022, P = 0.045). Comparison of contrast sensitivity between the two groups showed that the treatment group can be identified from the examination of 11 before treatment increased to 29 after treatment, the difference was statistically significant (χ2 = 4.572, P = 0.04), the treatment group from before treatment Of the 8 eyes increased to 12 after treatment. There was no significant difference in contrast between the two groups before treatment, and the contrast of treatment group was more obvious than that of control group after treatment (P <0.05). In the treatment group, the visual field of the last examination in 13 eyes was enlarged or the value of dB was increased by 10 eyes before treatment, and the visual field in 3 eyes was lost or no change. Of the 7 eyes in the control group, 3 eyes and 4 eyes showed no change in the improvement and loss of visual field. The treatment group before and after treatment is better than the control group. Conclusion Miocao treatment of optic nerve contusion is safe and effective, the restoration of visual function was significantly better than ordinary VitB12.