摘要
目的分析顺铂化疗致双眼中毒性视神经萎缩的主要原因,并分析临床治疗方法,总结临床疗效。方法选取2014年2月—2018年9月期间收治的3例恶性肿瘤患者作为研究对象,对患者临床资料进行回顾性分析,对双眼中毒性视神经萎缩发生的主要因素进行分析,并对临床治疗方法及效果进行探讨。结果该组3例患者均采用顺铂作为主要化疗药物,双眼中毒性视神经萎缩患者出现视力严重损伤的主要表现为:1例视觉电生理异常,1例为球后视神经炎,1例为非特异性视物模糊;通过对3例患者进行详细分析,认为化疗致视力损伤的原因与患者年龄、合并糖尿病等因素存在密切关系;该组患者出现双眼中毒性视神经萎缩后,均对化疗治疗方案进行调整,将顺铂改为洛铂,配合希存,同时给予眼底微循环、营养神经、控制高血糖症状等对症治疗,但是2例患者视功能无明显改善,1例患者双眼失明;3例患者出院后,未见肿瘤复发。结论顺铂化疗致双眼中毒性视神经萎缩与年龄、基础病存在一定关系,应在用药前对患者身体状况进行综合评价,尽量采取预防性措施,降低顺铂用药不良反应,最大程度保证患者治疗安全性。
Objective To analyze the main causes of toxic optic atrophy caused by cisplatin chemotherapy,and to analyze the clinical treatment methods and summarize the clinical efficacy.Methods Three patients with malignant tumors who were admitted between February 2014 and September 2018 were selected as the main subjects.The clinical data of the patients were retrospectively analyzed.The main factors of ocular optic atrophy in both eyes were analyzed and clinically analyzed.The treatment methods and effects were discussed.Results Three patients in this group used cisplatin as the main chemotherapy drug.The main manifestations of severe visual impairment in patients with bilateral optic necrosis were:1 case of visual electrophysiological abnormality,1 case of posterior optic neuritis,and 1 case of non-specificity visually obscured;through detailed analysis of 3 patients,it is believed that the cause of visual impairment caused by chemotherapy was closely related to the age of the patient,diabetes mellitus and other factors;in this group of patients,after both eyes had toxic optic atrophy,the chemotherapy treatment plan was adjusted,cisplatin was changed to lobaplatin,combined with Xicun,and given symptomatic treatment of fundus microcirculation,nutritional nerve,and control of hyperglycemia symptoms,but 2 patients had no obvious improvement in visual function,1 patient had blindness in both eyes;3 patients were discharged after that,no tumor recurrence was seen.Conclusion Cisplatininduced chemotherapy in both eyes has a certain relationship with age and underlying diseases.The patient's physical condition should be comprehensively evaluated before administration.Preventive measures should be taken to reduce the adverse reactions of cisplatin and ensure the safety of patients.
作者
纪新丽
王磊
JI Xin-li;WANG Lei(Department of Ophthalmology,People's Hospital of Chengyang District,Qingdao,Shandng Province 266100 China;Department of Oncology,People's Hospital of Chengyang District,Qingdao,Shandong Province,266100 China)
出处
《中外医疗》
2019年第22期17-19,共3页
China & Foreign Medical Treatment
关键词
中毒性视神经萎缩
双眼
顺铂
化疗
Toxic optic atrophy
Binocular
Cisplatin
Chemotherapy
