目的 探討復(fù)方樟柳堿注射液聯(lián)合鹽酸卡替洛爾滴眼液治療開角型青光眼的臨床療效。方法 選取遼寧省朝陽市中心醫(yī)院2017年1月—2019年6月收治的開角型青光眼患者82例（150眼）作為研究對象。將患者隨機分為對照組與觀察組，每組各41例。對照組給予鹽酸卡替洛爾滴眼液治療，每日早午飯后滴1滴眼液于結(jié)膜囊內(nèi)，手指壓迫內(nèi)眥角淚囊部5 min， 2次/d，治療4周。觀察組患者在對照組的基礎(chǔ)上聯(lián)合復(fù)方樟柳堿注射液治療，于患眼同側(cè)顳淺動脈旁皮下注射樟柳堿2 mL， 1次/d，14 d為一個療程，連續(xù)治療2個療程。觀察兩組患者的臨床療效，比較治療前后兩組患者的眼壓、視力、視野平均缺損（MD）、視野神經(jīng)寬度、以及眼部血管眼動脈（OA）、睫狀后短動脈（PCA）、視網(wǎng)膜中央動脈（CRA）的血管收縮期峰值血流速度（PSV）、舒張末期容量（EDV）、阻力指數(shù)（RI）、搏動指數(shù)（PI）等指標(biāo)。結(jié)果 治療后，觀察組改善率為96.05%，顯著高于對照組的81.08%（P<0.05）。治療后，兩組視力水平顯著升高，眼壓均顯著下降（P<0.05）；觀察組視力水平和眼壓顯著優(yōu)于對照組（P<0.05）。治療后與隨訪3個月，觀察組MD與視神經(jīng)寬度水平均顯著高于治療前（P<0.05）。治療后，兩組CRA、PCA的PSV、EDV呈升高趨勢，觀察組與治療前相比差異顯著（P<0.05），且與對照組相比差異明顯（P<0.05）。與治療前相比，觀察組OA的PSV、EDV值顯著升高，差異有統(tǒng)計學(xué)意義（P<0.05）。隨訪3個月，與治療前相比，觀察組CRA的PSV降低，EDV升高（P<0.05），PCA和OA的PSV、EDV均降低（P<0.05），觀察組隨訪3個月的CRA的PSV較對照組低、EDV更高，PCA的PSV、EDV較對照組低（P<0.05）。結(jié)論 復(fù)方樟柳堿注射液聯(lián)合鹽酸卡替洛爾滴眼液治療開角型青光眼患者可有效控制眼壓，同時還具有較好的視神經(jīng)保護作用，主要表現(xiàn)為改善視野平均缺損、視神經(jīng)寬度、眼血管血流參數(shù)，延緩視功能損害，療效顯著，值得臨床推廣。

Objective To explore the clinical effect of Compound Anisodine Hydrobromide Injection combined with Carteolol Hydrochloride Eye Drops in treatment of open-angle glaucoma. Methods A total of 82 patients (150 eyes) with open-angle glaucoma treated in Chaoyang Central Hospital from January 2017 to June 2019 were randomly divided into control group and observation group, and each group had 41 case. Patients in the control group were treated with Carteolol Hydrochloride Eye Drops, one drop was put into the conjunctival sac after brunch every day, fingers compressed the lacrimal sac at the inner canthus angle for 5 min, twice daily, and the treatment lasted for 4 weeks. Patients in the observation group were treated with Compound Anisodine Hydrobromide Injection on the basis of the control group, 2 mL was injected subcutaneously in the same side of temporal superficial artery of the affected eye, once daily, 14 days as a course of treatment, two courses of treatment were continuous. The clinical efficacy in two groups were observed, and the visual acuity, intraocular pressure, MD, optic nerve width, and the indexes of PSV, EDV, RI, and PI in the OA, PCA and CRA before and after treatment were compared. Results After treatment, the improvement rate of the observation group was 96.05%, which was significantly higher than 81.08% of the control group (P<0.05). After treatment, the visual acuity of in two groups was increased significantly, but the intraocular pressure was decreased significantly (P<0.05).After treatment, visual acuity and intraocular pressure in the observation group were significantly better than those in the control group (P<0.05). After treatment and follow-up for 3 months, MD and the width of and optic nerve in the observation group was significantly higher than those before treatment (P<0.05). After treatment, the PSV and EDV of CRA and PCA in two groups showed an increasing trend, and the difference between the observation group and the control group was significant (P<0.05). Compared with before treatment, PSV and EDV values of OA in the observation group were significantly increased (P<0.05). In the follow-up for 3 months, compared with that before treatment, PSV of the CRA was decreased, but EDV in the observation group were significantly decreased (P<0.05), and PSV and EDV of PCA and OA were decreased (P<0.05). The PSV of CRA in the observation group were lower than that in the control group, but EDV of the CRA in the observation group after 3-month follow-up were higher than that in the control group, and the PSV and EDV of the PCA were lower than those in the control group (P<0.05). Conclusion Compound Anisodine Hydrobromide Injection combined with Carteolol Hydrochloride Eye Drops in treatment of openangle glaucoma patients can effectively control the intraocular pressure, but also has good optic protection, mainly in order to improve the average visual defect, width of the optic nerve, eye vascular blood flow parameters, and delay the visual function damage, curative effect is distinct, which was worth clinical promotion.

R988.1