吸入性甲醇中毒致严重视力损害临床分析.pdfVIP

中国眼耳鼻喉科杂志 2013 年7 月第 13 卷第4 期 219 ·神经眼科专题· 吸入性甲醇中毒致严重视力损害临床分析 马甲华江汉秋张晓君 [摘要] 目的分析吸入性甲醇中毒致视力损害的临床特点及预后。方法 收集本科2∞3 年 1 月- 2013 年2 月吸入性甲醇中毒致视神经损害住院患者的临床资料。结果 本研究吸人性甲醇中毒性视神经病变 患者共5 例。甲醇接触时间为3 个月 -5 年。所有患者均急性起病，病程早期伴有全身中毒症状，同时出现双 眼严重的视力下降。视力下降3 d 内达峰，急性期5 例J患者Hl眼视力从无光感至0.05 ，均为全视野受累;病变 部位以球后部视神经受累为主，急4性期眼底视盘大致正常:视觉诱发电位均未引出固定波形:眼眶磁共振成像 提示双侧视神经眶内段、管内段信号增高，增强后轻度强化。经激素冲击及大量 B 族维生素辅助治疗。随访3 个月，除2 例接触时间较长(2 年、5 年患者)外，视力均有不同程度改善。结论 吸入性甲醇中毒可导致严重的 视神经损害，接触时间长者预后差。(中国眼耳鼻喉科杂志，2013 ， 13 :219-221) [关键词] 吸人性甲醇中毒; 视力损害; 视神经 αinical anaIysis of severe 由ualloss 曲U剑d by inhalational methanol toxicity MA Zhong-hl蝠， JIANG Han-qiu , Z出NG Xiao讪 岛De， 阳时阳ru 01 胁Æel川1T0logy ， 必Be钳φU， 拼u嗒z喀g r.岛on咿gren Iω7刀30， China Corresponding author :ZHANG Xiao-jun , Email: zxjune@gmai l. com [Ab剖ract 1 Objective To analyze the clinical features and prognosis of the visual loss resulted from methanol inhalation toxicity. Methods Data of hospitalized patients with inhalational methanol poisoning were 臼wyzed. ωults Five patients with optic neuropathy caused by inhalation toxicity of methanol were under observation , whose methanol- contact time spans were from 3 months to 5 ye缸8. Al l patients had acute onset , systemic symptoms early in the course , bo由 eyes involved , and severe visual impairment. After 3 days of onset , the visual ac山ty got worst. Ten eye-si拚ts of five patients were from no-light-perception to 0.05 , with full vision fields lost. Retrobulbar optic nerves were the major sites involved , and optic discs were normal on the acute stage. Visual evoked potentials were not observed with fixed waveform. Orbital magnetic resonance imaging indicated increased signal of hilateral optic nerves in the orhit and the canal ，皿d sl