单侧动眼神经麻痹36例临床分析.docVIP

单侧动眼神经麻痹36例临床分析 　　[摘要]目的 探讨动眼神经麻痹的病因、治疗以及预后，提高对该病的认识，以便早期治疗，尽量减少并发症的损害。 方法 回顾性分析本院2009年4月～2012年6月诊断为单侧动眼神经麻痹的36例住院患者的临床资料。 结果 本文中单侧动眼神经麻痹的主要病因为糖尿病性外周神经麻痹（50.0%），其次为颅底动脉瘤（22.2%）；Tolosa-Hunt综合征（8.33%），外伤性（8.33%），虽然经一系列的检查（如：DSA、MRI、颈内血管超声等）仍有l1.1%的患者不能明确致病原因。病因不同预后不同。收入单侧动眼神经麻痹患者最多的科室依次为神经内科（21例），神经外科（6例）、内分泌科（5例）以及眼科（4例）。 结论 引起单侧动眼神经麻痹的病因多样；仍需临床资料的不断积累才能确定各种病因引起的单侧动眼神经麻痹患者的最佳治疗方案。临床遇单侧动眼神经麻痹的患者应该充分考虑颅内动脉瘤的危险性。 　　[关键词]动眼神经麻痹；糖尿病；动脉瘤；Tolosa-Hunt综合征 　　[中图分类号] R745 [文献标识码] B [文章编号] 2095-0616（2013）22-208-03 　　Clinical analysis of 36 cases of unilateral oculomotor paralysis 　　LIU Yuenan 　　Department of Neurology， Dingli Clinical College of Wenzhou Medical College， the Central Hospital of Wenzhou， Wenzhou 325000， China 　　[Abstract] Objective To investigate the etiology， treatment and prognosis of oculomotor paralysis to raise the awareness of the disease for early treatment and as far as possible reduce the damage of complications. Methods 36 inpatients with unilateral oculomotor paralysis diagnosed in our hospital from April 2009 to June 2012 were retrospectively analyzed. Results The main cause of unilateral oculomotor paralysis in the article was the diabetic peripheral nerve paralysis（50.0%）， followed by the basilar artery aneurysm（22.2%）， Tolosa-Hunt syndrome（8.33%）， trauma（8.33%）.There were still l1.1% patients unable to clarify the causes after a series of examinations（such as DSA， MRI， internal carotid ultrasound）.The prognosis was different for different causes. The most department having the patients with unilateral oculomotor paralysis was neurology department（21 cases）， neurosurgery department（6 cases）， endocrinology department（5 cases） and ophthalmology department（4 cases） in turn. Conclusion The cause of unilateral oculomotor paralysis is diverse； As the clinical data accumulate， the best treatment method of unilateral oculomotor paralysis caused by various etiological factors will determine. The patients with unilateral oculomotor paralysis should