摘要
目的:分析影响眶内电针治疗缺血性脑卒中后外展神经麻痹的疗效及相关因素。方法:回顾整理2013年1月至2019年6月期间接受眶内电针治疗的缺血性脑卒中后外展神经麻痹患者的临床资料,以疗效痊愈为结局指标。比较痊愈组与未痊愈组患者的性别、年龄、发病时间、治疗次数、血压、血脂、同型半胱氨酸(Hcy)等因素。结果:共纳入112例患者,痊愈34例,有效55例,无效23例,总有效率79.47%。治疗前、后患者水平最大复视角度中位数分别为18.25°和7.03°,眼位评分中位数分别为2分和1分,差异均有统计学意义(P<0.01)。与未痊愈组相比,痊愈组患者的外展神经麻痹程度较轻,发病时间较短,治疗次数较多,高血压、高血脂、缺血性心脏病和高同型半胱氨酸血症(HHcy)患者比例较低(均P<0.05)。Logistic多因素回归分析结果表明,外展神经麻痹程度、发病时间、HHcy是影响疗效的危险因素(β=-1.763,P=0.001;β=-0.038,P=0.013;β=-2.782,P=0.000),治疗次数是影响疗效的保护性因素(β=0.060,P=0.002)。结论:眶内电针能够改善甚至消除缺血性脑卒中后外展神经麻痹患者的复视、眼球运动障碍症状,对外展神经麻痹的功能重建有一定的促进作用。其临床治疗效果受患者的发病时间、治疗次数、外展神经麻痹程度、Hcy水平等因素影响。
Objective:To analyze the effectiveness and related factors of orbital electroacupuncture in the treatment of abducens nerve palsy following ischemic stroke.Methods:We summarized the clinical data of patients from January 2013 to June 2019 who suffered abducens nerve palsy following ischemic stroke and were treated with intraorbital electroacupuncture.Complete recovery was set as the outcome indicator.Factors such as gender,age,disease duration,number of treatments,blood pressure,blood lipid,and homocysteine(Hcy)were analyzed and compared between the recovered patients and non-recovered patients.Results:A total of 112 patients meeting the inclusion criteria were enrolled in this study,including 34 cured patients,55 patients with improvement,and 23 patients without improvement;the overall effectiveness was 79.47%.The median maximal diplopia angle before and after treatment was 18.25°and 7.03°,respectively,and the median ocular position score before and after treatment was 2 and 1,respectively;the differences in values before and after treatment were statistically significant(P<0.01).Compared to non-recovered patients,recovered patients experienced milder abducens nerve palsy,a shorter disease duration,a greater number of treatments,and a smaller proportion of recovered patients with hypertension,hyperlipidemia,ischemic heart disease,and hyperhomocysteinemia(HHcy);these results were statistically significant(all P<0.05).Multivariate logistic regression analysis showed that the severity of abducens nerve palsy,disease duration,and HHCy were risk factors of treatment effectiveness(P=-1.763,P=0.001;β=-0.038,P=0.013;β=-2.782,P=0.000),and the number of acupuncture sessions was a protective factor(β=0.060,P=0.002).Conclusion:Intraorbital electroacupuncture can improve or even eliminate diplopia and eye movement disorders in patients with abducens nerve palsy following ischemic stroke,and it promotes functional recovery after abducens nerve palsy.The curative effect is influenced by factors including the disease duration,number of treatments,severity of the palsy,and HHcy.
作者
段春晓
刘铁镌
栗雪梅
苏畅
魏鑫甜
刘畅
周凌云
DUAN Chun-xiao;LIU Tie-juan;LI Xue-mei;SU Chang;WEI Xin-tian;LIU Chang;ZHOU Ling-yun(Department of Acupuncture&Eyeball Movement Disorder Treating Center,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《神经损伤与功能重建》
2021年第4期195-198,共4页
Neural Injury and Functional Reconstruction
基金
国家自然科学基金(No.81674052)
黑龙江省中医药科研项目(No.ZHY18-147)
黑龙江中医药科研项目(No.ZHY12-W031)。
关键词
缺血性脑卒中
外展神经麻痹
康复
复视
电针
ischemic stroke
abducens paralysis
rehabilitation
diplopia
electroacupuncture
